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HomeMy WebLinkAboutSanfordpermitALL APPLICABLE INFO MUST BE COMPLETED FpR gppi,1eATEON TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Servlces BuIlding and Code Regulatlon Divlslor, 2300 Vlrglnla Avenue, Fort Plerce FL 34982 Phone, (772) 462.1553 Fax: (772) 462.1578 Commercial ROsldentlal PERMIT APPLICATION 'OR: To Select from dropbox, click Mere PROPOSI�D IN PR OUEMENT'LC}CATI:ON; Address; { i' A�- Legal Description: Property Tax 1D #: ` p q it 7 Site plan Name: Lot No. Project Name: Block No, Set11 backs FrontSack: �.� Right Side: Left Side D ETAitt 04ESCRIPTION OF'WORK V VV +-Y 4e,-AA�- ti 4-- �` U Ct C[ c�Y� 71/ CONSTiUCTINFORMATIN;. tfona war ab e e orme un er i s perrra ,» c ec a HVAC app y: Gas Tankpiping E]Gas [Ilectric Shutters Windows/Doors Plumbing []Sprinklers Generator � Roof Total Sq. Ft of Construction: Cost of Construction: �, S Ft. of First Floor: $ j 'i �. � '""-� Utliities: Sewer i �I Septic Building Height: OW[VIyR%LSS,EE Name CONTRACTOR: Address: 1—Gi 5¢Z - Name: QN rtri f,�rA City: ,fir SI [ G� company: �.(� � � t�(. �� C _ /�l � C'i-ail ZIP Code: G �— Fax: State: Address: 5C �t� �� ,—.,�;.rS6barf/L� Phone No, City: �d>�t E<-M.all: ' ZIP Code: 129 Ile �e —•--�„ _ �_Fax: 77.2 Fill in fee simple Title Holder on next page (If different Ma E Phone N from the Owner listed above) - If Cad_ ic, -V-�'3 If vstate or County License: Cr✓ alue of construction is $25a0 ar more, a RECORdED EVotice of Comm �� � encsrrtient is required, �~ �� of App 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 Countty� makes no yrepresentation that is granting a permit will authorize the permit holder to build the subject structure structures. Pleaseeconsult w�thpyourHome OwnOwners ociation and review deed oroany restrictions whichrmay aY prohibit..such In' consideration of the granting of this requested permit, 1 do hereby agree that l 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, wails, 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 tMprovernents to your property, A Notice of Commencement must be recorded and posted oil the jobsite before site first lnspection..lf you intend to obtain financing, consu efrel -a attorney before w Sigrature of;0wrierl Lessee/Agent co STATE OF FLORIDA COUNTY - �t��t' The for oing Instrument was acknowledged before ,� � � -S this -L;2 day of T ' ''- ( 20 Eby (Namepf person ackwv led,�ing j 4 zy ; '(Signature of Notary Public- State of Florida ) Personally Known L-�013 Produced Identification Type of identification Produced Commission No.r (Seal} Revised 07115/2014 STATE OF FL®R T Q] COUNTY OF � The forgoing instrument was acknowledged��laefore m this day of _ , 20;--�- by a w Personally Known i- :• OR Produced identification Type of Identification Produced Commission No, rF`t dl (Seal) REVIEWS FRONT ZONING SUPERViSOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS