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HomeMy WebLinkAboutlanninAll APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED date: ��rT�r 1 Permit Number: - r is - - " y Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: Address: � i Legal tion: Desa �L� 1 �� Property Tax ID Block No. Site Plan Name: Project Name: co+h�rlee Frnnt Back: Right Side: Left Side: Mechanical — Gas Tank —Gas Piping Shutters Winclows/uoors Electric -Alumbing — Sprinklers Generator _ Roof Pitch Total Sq. Ft of Construction: �© cost of Construction: $ l ' - Sq. Ft- of First Floor: — Utilities: _Sewer _Septic Name �' L D�yl �► iva[ne: -r<• i Address: %.9 � Company: city: NO r ` ip-1 State:l A Address: j Pf� Zip Code: Q 0 C,1 Fax: city: 0 Phone No. �~ Zip Code: E-Mail: �� Phone No Fili in fee simple Title Holder on next page (if different E-Mail. 4-1 j r from the Owner listed above) State or County License. If Value of constr ction is 75oo or more, a RECORDED Notice of commencement is required. —x 11 e to obtain a permit to do the work and installation as indicated. OWNER/ CONTRACTOR AFFIDVIT. Application is hereby mad i certify that no work or insMilation has commenced prior to the issuance of a permit St Lucie Connert� makes no representation that i5 granting a permit will authorizethe permit holdertn build the subject structure which is inPcon litconsulany applicable ppl tar Home Home owners rs AssociationAssociation Rndrules, b your or foand covenants any ai s�tritt�4ns which ay applyhi[�R s�sch structure. perform the work in consideration of the granting of this requested permit, I do hereby agree that I Will, in all respects, P in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. from The following building permit applications fences, walls, igns screen undergoing rooms and accessory uses to anotheraon-residential use accessary structures, swimming p twicefor improv m TO OWNER: A Notice of Commencement must be recorded nt result rid in pasteour d oint heSobsite improvementsto your property. before the first inspection. if you intend to obtain financing, consult with lender or an attorney before rnmmeneirng work or recordi6gyourNdofice of Commencement a� Signature a owner/ i Pssee/ ctractor as Agentfor Owner STATE OF FLORIDA COUNTY OF .� l'i` L-?( The forgoing instruMerlit wasacknowledge before me this day oftJ k ► 20 by 0411 e {Vamp of person making statement. Personally Known OR produced identification Type of ldentificati n (Signature of uliijw� 10 nda commisMon N � P Con IIING SUPE �R=11.tS LATE F-Co REV DATE RECEIVED BATE COMPLET7ED7 VISOR EW of contractor/license Holder STATE OF FLORIDA COUNTY OF: � 4� A) 2W Thefo inginstrrimenttriasacknowk ogedbtioreme this ar day of I LJ a / J y r1 I C� Few lL-Q 7�L Name of person making statement Personally Known OR Produced Identification Type of Identification (Signature of f `F' pamela Dyer --Rape Commission 1,,7,n GG 4 ) PLANS MANGROV REVIEW I V RBREWON I S R VIEWATURTLE REVIEW E eu i7