HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: u _� Peffnk.Number: 111-A -
RECEIVED
Building Permit Application NOV 2 2018
Planning and Development Services
Building and Code Regula0an Divi nn ST. Lucie bounty, Permitting.1
23W irrginiaAvenue,Fort Pierre FL 34982
Phone:(772)462-2553 Fax(972)462-1578 -Commercial Residential
PERMIT APPUCATION FOR: To Select from dropbax, dick arrow at the end of tine
'PROPOSEQ�IMPROVEMENT IOCATI4N:. :: Y. : -
Address:
Legal Description: � �T o � � 6 C�Jif l n
e-6tQv At 4,1 Tu
Property Tax ID#: �' - U 0�` Lot No., —
Site Plan Name: -- x Block No.
:Project Name-
Setbadcs Front Badc Right Side. Left Side:
DETAILEQ DESCRIPTION 0-F-tAf'4RKi
v, I I FV6U+ e47fi6 a,,C C? -5 [kyPle..
a
piU5TRt1CTlOIV INFORMATION
Additional w00 DSjpVWrmed un u permit– - -a
HVAC Gas Tank []Gas Piping, `_Sapphuhur... Windows/Doors
Electric Plumbing OSpriniers. r]Generator L=J Roof
Total Sq.Ft of Construction:_ ! .Ft.of FirstFlloor.
of Construction:$ (56' Util'diesSewer L_J_Septic Building Height
01NNERjLES$EE• _ . . ..:. . . :: : =, .:-: _ CONTRACTOR. � -
Name Name:
Address: - Company:
City: " State.- At
Tip Code: Fax14 C+ty: �f f ''_ St�'te=�~
Phone No.. 7 — � f _ Zip Code.r �� s FaX_ 44 ym
E-Mail: Phone No.
Fill in fee simple Tide Holder on next page(if different E Mail: K t1&cgGd
from the Owner listed above) State or Cou 'cense- -
if value of amsb arfion is$2500 or more,a RECORDED Notice of CoA is req1fifed.
Y`
DESIGN ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name- Name:
Address: Address•
City:
State:. City: state:
Zip: Phone: Zip: Phone:
FEE SIMPLE TME HOLDER:• ' Not Applicable BONDING COMPANY: Not Applicable
Name: - Name:
Address: Address: '
CRT. 011r.
Zip Phone: zip: Phoom .
I certify tlmt no work or instaiiation!as commenced priorto the issuance of a permit
S#.Lurie Cou nwkes no rep that isgrantingapermity a orizetlse hol to bind thesubjectstructure
whkh is in ac n with me Ownts Association rotes, or an nt s may resu tar prohibit such
structure.Please ccnsiak our Nome owners Association and;;Z;your deed r arty restrictions which may apply.
in consideration ofthe granting of this requested permit,I do herel4tagree that t wiil,in all respects,perform the work
In accordance with the app med pims,the Florida Building Codes and 5t.Lude County Amendments.
'fie followfig'biiiidtng permit applications are exempt from undergobrg a full concurrency rewew:room additions,
accessorystructures„swimming p00%fbnees,walk signs,scremmonmW accessory uses to another nowreddenthil use
WARNING TO f OWNER:Your failure t*Reeard a NotkoofCommena want may ees+*In your-vayteg twice for
impprovements to your prgperty.A Nonce of Commencement must be recorded and 0oSbed on the jobsite
before the firxt inspection.>f you jntend to obtain financing,consult with lender or an attorney before
oommendna work or recordifix yqur Notice of ComrhenoeM
re of OwnersOaftm of Comer Holder•
STATE OF FWRiDA L STATi`OF FLORIDACOEN"" zl. uell E COERMOF.-- t4, - I I )Q,IF,-
The (rrstrum was�_ me The r� fnstrume was adeno befareme
by this t�of .2A by
•/- _
11�me of person acicnaneleclgtng l Rl�iame of Perste acknowledging)
1
iSigrradrre4L
of Notary -State Florid j (Shire of Notary -State of tgorida)
P+ersanaily Known - OR Producedlderstrfrcatian Personally Known �OR Produced Identification
Tvpeof identlfloa m Producer! Type of Identification Produced
Commission No. mission Na -
-car.
i`01 YPip/,' KAREN S 'NUELSEN ,�;, ,1 ,� KAREN S. NIELSEN--
blic
=' *= Commission # GG 207484 + Commission # GG 207484
�eViSt �7� 1,4 -'�;1��f���•- My Commission Expires ,�,� �i My Commission Exprtes
++++"` June 124 2022 'n�i+s���` June-12, 2022
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