HomeMy WebLinkAboutBuilding Permit Application _____
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 I-.1- kS Permit Number: 1 i t ' 0 1 0(7
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COUNTY
FLORIO /1
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Buiing Permit Application
Planning and Development Services P I 9n.
Building and Code Regulation Division 'filytti
St , 1744189 oe„
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 2 SO D.- c)e-ox> 1.* L-Crse-
Legal Description: Lak,..0.-(.000 d Pelck-
Property Tax ID#:k3c3k,-GDR-0 L42-6o0-0 Lot No.9,i 0
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work to be ertormed under this permit-check air apply:
1--HVAC Gas Tank [ Gas Piping Shutters 2/\1findows./_p
-
Electric I. Plumbing Sprinklers _Generator _ Roof
Total Sq. Ft of Construction: Sajli of First Floor:
Cost of Construction:$ 1,t"5-6 .. — Utilities: I iSewer Septic Building Height:
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Na me.... dr's i" CV- e'...:.1,1;at-, ktacf- Name: "-- q,.Jc‘i..,se,i cp 4-
Address: 73 Oa Pe_A-IrN kl Lei ne- Company:.,..5-4,--C) OCA I-9E.to-k-c-k - --A-') Q.
City: fQcf p:e....i-c_.e- State: Fl Address: 1:2)4 (p k -79111 O- -- A.2,'
Zip Codp:3(4615/ Fax: City: i-0 k_'11---i kirstr: *''C-10 t State: F'-
Phone No. 1a-5q,5 -qoFt? Zip Code:3S1-i I - Fax: 57..pi , 4/059
E-Mail: Phone No. 'L !- S' s--5--. 4.-/05 .2.,
Fill in fee simple Title Holder on next page(if different E-Mail:
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from the Owner listed above) State or County License: 0 (9 Co;:)...c.)--Gi 31
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i- ,
DESIGNER/ENGINEER: __w�'Applicable" MORTGAGE COMPANY: __mou*ppmable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
,
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
'
I certify that no woror installation has commenced prior to the issuance of a permit.
St.Lucie County.makes no representation that is granting a permit will authorize the permit holder to build the
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby that I will,iU respects,perfonnthewor
in accordance with the 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,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before .
commencing work or recording your Notice of Commencement.
a - cle~
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nature of Owner!Lessee/Agent =nfControcton/UcenseHo}der
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STATE OF FLORIDA1XfK�
STATE OF F��� / �."�/~'{� /-
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Personally Known OR ProduntiNaton^~k-- Personally Known . 'O
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roduced Identificat
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Type of Identification Produced (---(-`. /Y--- Type of Identification Produced ANGELAYOUNG
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Commission No. / / / /° �7f� (� LAWRENCE RADA No. ^ �'-'�� ` EXPIRES:-----2umo
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STATE OF FLORIDA
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40or^' Exonao11/11/2010
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE -
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