HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF/OO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q d
Date: � _/ ( Permit Number.
rhs RECEIVED
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Building Permit Application S-EP 17 2019
Planning and Development Services
Buildng and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line-I%- '
PROPOSED IMPROVEMENT LOCATION
Address:�� /� G' GL C'i O ("a
Legal Description:
.Property Tax 1D#: ��a�' \ - O d(�C'�c30— Lot No.
Site Plan Name: L V' r Block No.
Project Name:
Setbacks Front Back: Right.Side:, Left Side:
DETAILED DESCRIPTION OF WORK
C65 b4c-/C r4 ffo l oxo
CONSTRUCTION INFORMATION =
Additional work to be erformed un er t is permit—cec all appy:
HVAC Gas Tank EjGas Piping v Shutters Q Windows/Doors
QElectric 0
Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: 2�Q d Sq.Ft.of First Floor:
Cost of Construction:$ Utilittes:11 Sewer O Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name 11 A e.. G S'S'C Name:
• Address: cc*v6 C Company: r e rr21/�
City: a State: Address: to Ae= 4
d.
Zip Code:. Fax: City: Ff 1 zrl�er State• /�
Phone No._-? ) .�' Zip Code:J fir(6*�I— Fax:
E-Mail: /r///-1 Phone No._—) 6/--.Q !
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or Coun 'cense:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i
DESIGNE GINEER: Not Applicable MORTGAGE COMPANY: Not Ap!Uwmble
Name: Name. -`
Address: Address:
Mr. State: City. State:
Zap: Phone: Zip: Phone
FEE SIMPIE MU HOLDER:- ' Not Applicable BONDING COMPANY: Not Applicable
Name:..' - Name:
Address: Address -
tStSr.
Zip: Picone: zip: Phone:
I cwt that no ivo rk or hatallatlon has commenced prior to the Iss nince of a permit
St Lucie Cou no rep on that Ls granting a mitt'y� the holder n build the sub,(ect lure
v+vhidr is a6dtevai ap�S��Home Owners Aon rules,ir�y�n�or an�ntslhat may resb�iCt rpm such
structrrm Please cwmnws ta+w th your Nome Owners Assocb— n and review your deed for any restrictions whkh etely apply.
In a maideation ofthe granft ofthis requested permit,i do hereby agree that i will,in all respec4 pevrform!fie work
iA accmdan cewith.the approved ptarm the Hod&SulldingCodesand St Lente Cou»tyArnendrnaft
The permit apppcodons are exempUmm underg t a full concurrency review:room additions,
accessarystructures,swimming pook fences,walls; aaoess+ory use'sto o another non-reddentlat use
WARNING TO OWNER:Your failureto Record a Notice of Commencement may result in your4wAngtwice1or
Int provements to your pn�perty.A Notice of Commencement must be recorded and.pasted on the jobsite
before the first inspection.>f you intend to obtain financing,consult with h lender or an attorney before
cornowdrin work or recordine your Notice of iCommenceMent
C
Signature of Ovr /Agent!Lessee Signature of Contrador Holder-
STATE OF RORiDA STATE OF R ORIDII M
COUMYYOF 5�- . i--Uc�e COUMYOF S
.The umuinstrument was adatbnrWpd Wore.me The uubumen t was admawledged beforeme
t*_A 1 daffy of 4e pA - 20 aby lids da of 20.fi bV _
i4#
(Name of personadcnawtedging}.• (Namea>#persorrar nowtedging)
(Signature of Notary c-State of Florida) (Signet m of N biiC State of Florida) .
Persorift Krum OR Produced identfication Persorragy Known OR Protluced ldentihCation
Type of identification Pmduoed _ �' Type of Identification Produced
Commisafan Ntx t`� c Eo> s ` � � S -
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REVIEWS - FRONT ZONING SUPIMMOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE - -
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