HomeMy WebLinkAboutSCN_0014ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z J 3� I Permit Number:
•`'
YYSry,� `a Y .
- Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-157$ Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
-__
Address: qb e✓ U
Legal Description: Alti (ts �alti�i Z/1 G A CmndO ' S��tii —71- Parcel
q6 4Ad
PCo-rotku ,yk common P(tnntof5 (Br 835-- 2-131,
Property Tax ID ;i: _ yffD Z Sol ` OZ 921-000 -
Lot No.
Site Plan Name: �binwv'GW� ��
Block No.
Project Name: G,0
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIP s ION OF WORK:
SUPPLEMENT AL CONS T RUC TION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
1 MORTGAGE COMPANY: _ Not Applicable
Name:f
Name:
Address:
i
j Address:
City: State:
City: State:
Zip: Phone:
I Zip: Phone:
j FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: ^Not Applicable
Name:
Name: _^
Address:
Address:
City:
City:
Zip: Phone:
i Zip: Phone: i
I certify that no work or 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 subject structure I
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such I
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 agree that 1 will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. r
i
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
i
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for i
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 our Notice of Commencement.
- - LZ . _10,;(:: 1
_ -i
`'� s
ISuture of Crwner/Lessee/Cofitractor as Agent for Owner
Signa e of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF -1' �C)CA i I
STATE OF FLORIDA
COUNTY OF �T L L) t-1 r=`
�I
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
.3 day 20 by
this day of � e-" o� 20 lib}"
this of
(Name of person acknowledging } i
I
(Name of person acknowledging)
i
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Personally Known OR Produced Identification K
Personally Known OR Produced Identification_
Fl— D
Type of Identification Produced PL -D l—
Type of Identification Produced _
I Commission No. �������� THE $ARANTOS
I
Commission No
o�Pµv PUB���i THEGDORE SARANTOS
Notary Public State of Florida
;
�; .°�= Notar Public -State of Florida
=
My Comm. Expires Nov 3, 2020
Revised 07/15/ r',�; ;,t••`'�
' ° Commission At GG 044773
iN) t.
=.;My Comm. Expires Nov 3, 2020
•�,��,,,•••d'•,
REVIEWS
FRONT
I ZONING
SUPERVISOR j PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
!!
COMPLETE
' I
[TN�ITIALS
I�