HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Permit N f er Ag;' F V1� 3
�r t
Building"Perm t.Applica ion OCT Ora' 2M
Planning and Development Services P e i m I tt i l l g i,...'YW r;a ��"Li"
f1Ll1l:
Building and Code.Regulation Division"
2300 Virginia Avenue„Fort Pierce-FL ��°�I� L'Con`trr FL
Phone:(772)4624553 Fax:(772)462-1578 Commercialesi enfial--
PERMIT APPLICATION FOR: To Select from dropbox click arrow-at the end:of line
PROPOSED rlNfzt?ROUEMENT LOCATION
Address: St
Legal Description:
µ
'Property-Tax-1 D:# �( a 3' 33 .2 .00" 5� OG0— Lot No..
Site;Plan Name: Slo&'No.
Project Name:
Setbacks Front, Back: Right Side: Left Side:
DETAILED DESCRIPTION} WQRK .
--
-Y. -
+ Z q`147l s v 0 POOL o77
�30NSTRUCTt�N`INFORM°ATION �
Adclitional,work to be nertormed, .,under this permit—`c e*r aM
appy:
r'
OHVAC Gas Tank El'Gas"Piping Shutters Q tNindows/Doors
'Electric Plumbing. �-Sprinklers Generator E,Roof Roof pitch
Total Sq...Ft of Construction: S Ft:of First Floor:.
Cost of Construction:.$ Z1.3 3" Utilities:;Sewer ESeptic Building Height:;
-
QWN�ER/LESSEE'
Name- 4 NC' Name: (,A 314
Address:. 0. N Company., ^,/vc ...CO �/' .S..
City N=fi. PrFIi(Gt State: L. Address: St•✓
Zip•Code -3 y q qqL Fax: City: S State
Phone No.,712- 7l3' od802_ Zip Code 3 V q T fax
E Mail: 77L
gL
Phone No 7r3y
fill m:#ee simple'Tit1e;Holder on next'page(�f different E Mail: 17 I �N.�:N 73
from-the Owner listed:above)' State,or County License. 30Y
y
If value of construction is$2500'6r more;a RECORDED Notate of Commencementis required:
pS,UPPI�EMENTgALCONSTR�U�CT,I°�NiIL�ENI LAW�IN�FORMATIO`N� �, A � f.
DESIGN.ERANGINEER: _Not Applicable MORTGAGE COMPANY: i Not Applicable
Name: Name:
Address: Address:
City State: City: State:
Phone. Zip: Phone:.
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDIING COMPANY: Not Applicable
rne Name:
Address:. Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIUVIT:Application is hereby made to obtain a.permit.to do the,work and.installationas indicated.
I certify that no work or installation:has corrimenced prior to the issuance of a permit.
St:Lucie County makes_no representation-that is granting a.permit will authorize the:ppermit holder,to;bwld the subject structure
which Is In;con Ict with:any-applicable Home Owners Association rules,bylaws or.and covenants that may restrict or;prohlbltsuch
structure'Please consult with your Home Owridrs,Associ6tion and,review your deed for any fdstnction`swhich.may-apply.
In consideration of thegranting of.this requeAed'permit,i do herebyagree that I will,in all,respects,perform the work K
in;accordance withtthe;approved plans,the Florida;Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing"a full concurrency review:room additions,
accessory-structures,swimming pools,fences,wall`s,signs,screen-rooms and accessory uses to another non-residential use
WARNING,TOOWNER:Your failure to Record a Notice of.Commencement may;result;in;your paying twice for
irnprovementsao,your property.A Notice of Cornmencernent.mustlbe recorded and=posted=on the':jobsite
before;the first sp
-inection ;If:you intend to obtain financing,consult with.lender Or a'K ttorney before
commencir :work or recordin ,our Not-ice,_of Commencement.
S ature of Ownerl`i:essee/Contractor as Agent for Owner Signature'of Contractor/License-Holder
STATE OF FLORIDA- $TATEsPF FLORIDA.
COUNTY OF i¢C/+'l -�j" f}�H COUNTY OE PCM 13 Fi44
The forgoing Instrument was acknowledged,before me The forgoing instrument wasacknowledged before me
'Ais—.!,L daay.of—&O)£/ . 20JZ bythis__Y- day.of vCppva&( " 2i by
-A&
f person°maks g statement ame of persorrmakih statement
Personally Known OR,Protluced Identification Personally Known OR Produced Identification.
-Type of Identificatlo Type of Identification•
Produced Produced K DL M1 2 D.- Sfd-7 3-
Si nature of Nota P`ubli Ignature of Notary Public S
I g ry ANGELA D STOWESIP R' ANGELA D STONESI
Gornmission•No: 12337 MdI�IMISSION#6Gt2 ,mmission No.CS120."3 7 nA(6�f�!IAAISSION.#GG1 7
,F EXPIRES June29;2021 ".'iaEXPIRES June 29
REVIEWS FRONT `ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE-1
COUNTER 'REVIEW REVIEW' 'REVIEW' REVIEW REVIEW 'REVIEW
DATE
•.RECEIVED`
DATE
COMPLETED
Rev 8%2%17