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HomeMy WebLinkAboutbackofappALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION Tp BE ACCEPTEDDate; Permit Number: Planning and DevelopmeniServices Building Permit Appikatran Building and Code Regulation Division 2300 Virginia Avenue, Fart Plerce FL 3498,E Phone: (772) 462-1553 Fax; 772 452-1578 - Commercial PERMIT APPLICATION FOR. Residel�tiai To Select from dropbox, click here Izopos IQ 1UPROVEMIE°NT:LVCATI .N. Address: rP ii lV ' Legal Descriptio 11'- S 4 i FL g 21 f Property Tax ID ##: 13Cj Site Pian Name: Lot No. Project Name: —"" Block No, Setbacks Front ------, Back. Right Side, Left Side; DE1"AILt. DQ,SCRipT10lV. pE WOK V1f. #✓ IlL LiE. . fel 4 ,a .c lLa' r <<� � Z 0A 71 L CONN#iUG1It3NNFORMATI(]l t ono wor a arms un er sperm —c ec a i iHVAC Cas Tankapp Y: Gas Piping _, Shutn Electric F i"``� iers Windows/Doors Plumbing Sprinklers Generator Tota) Sq. Ft of Construction: Roof Cost of construction; $ SCI. Ft. of First Floor: Utilities: Sewer ZSe,ptic Buil (?DTII L—E SEE; atine Height. Name 1l,°l CC3NTRACTC}R: Address; Name ON -/i'j tR bA "T&P-4A City: F.-_ IC'[c, Company:! e/ C'c Zip Code: -Si-1 `1 S i _FL- Address: SC A 1-,) Phone No.Fax: ' City:rLye- 1-72 ]-73- L U E T Luca ZIP Code: �3 �I� State: r4- Fax: 7'7c2 Fill in fes simple title Holder on next page ( If different Phone No. from the Owner listed ab�$2500 �ror E-Mail. 21 State or County License:. If ualue �cn rtactlon e, aREC©RDI:D Notice 4f Comms 11 mentis required. �� Name: Address: --- City: State: Zip; Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address City' Zip' Phone: MORTGAGE COMPANY: Not Applicable Name, Address: City, State: Zip: Phone: BONDING COMPANY: ____Not Applicable Name: Address.• City: Zip: Phone' I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Counttyy snakes no representation that Is granting a permit will authorize the permit holder to build the subjects ruct6re W is in cant7ict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or pro�lbit 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 agree that i will, In all respects, perform the work 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-residentlai use. WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for trnprovernents tgour gope�rty. A Notice of Commencement must be recorded and hosted on the jobsite before first intend to oi�tain f#nancingp consu manattorney before I?3F' i�eE1L'li'»jn,er lUn+i, c ..x v�. _ _�__ __._ �.=Slgniturelof:Ownerf Lessee/Agent a, STATE OF FLORIDA M COUNTY OF The forgoing Instrument was acknowledged before J a this �dayof 20 4_by ig' 43 SCE person i.:Pignauure or Notary Public- State of Florida ) Personally Known �-OR Produced identification Type of identification Produced Commission No.) ""' � ' �. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW COMPLETE INITIALS Signature STATE OF FLOR��� T? COUNTY OF - c�t-� � a c The forgoing Instrument was acknowledged before m , X a this � day of 1Vl H �-C 20 I `1 by = 1-= 2 .fes n '�'w Personally Known I/�OR Produced identification Type of Identification Produced Commission No, E!2 ,-al (Seal) PLANS I VEGETATION SEATURTLE I MANGROVE REVIEW I REVIEW I REVIEW REVIEW