HomeMy WebLinkAboutBuilding Permit Application— -- ---• • - - i wn -rnvvi r : application is hereby made to obtain a permit to do the work and installation as indicated.
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
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit 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 f0owing 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
WARNING TO OWNER: Your failure to Record a Notice of Commencement may resu��n your paying twice for
improvements to ygdFr 3ropey y�otice of Commencement must be record e 'anl' posted the jobsite
before the first ins ection. If .ou In end to obtain financing, consu th lenor organ atw rney before
commencing work or r' Gordan out Notice of Commencement.
Signature of O `Her/ Lessee/Contractor as Ageht for Owner
�� 1
STATE OF F d'RIDA
COUNTY O k 4r
The f ing instrument was a knowledgecl f efore me
this �da of 6`X by
Name of person making statement
Personally Known yL
OR Produced Ident' c
Type of Identification
Produced
( ignaturof N ary Public- Sta e of FI
Commissi:n o o O Nr
Notary Public State��f���rida
x
i E� Riccaboni
y'f
My Gommissior FF 981647
oo cti�
Exo res 9512812020
REVIEWS FRONT ZONING
COUNTER I REVIEW
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signature of ContrActor/License
STATE OF FLORIDA
COUNTY OF /
The fAirigoing Ptrurnent was acknowledged before me
this ` fA_-. dayof ZpA5y
Name of person making statement
Personally Known OR Produced Identific
Type of Identification
Produced
Signature of Nota l'c-.S�a f L,�cEr
COmm15510 �sY p�o4 h!o[ary Public Slate of F rich
aboni ea!)
y r_ nny Commission FF 981647
��os FtiQ¢� ExRires t7512&f202a
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Plonning and Development Services
Building and Code Regulation Division
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
PROPOSED IMPROVEMENT LOCATION:
Address: i eGji4_ l'nri't i w' 4,vY
Legal Description:
Property Tax ID #: 0 t
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
Left Side:
DETAILED DESCRIPTION OF WORK:
kP,mo l'e re () lace--. ter I.C'12—
CONSTRUCTION INFORMATION:
itiona wor to e e urine un er t is permit — c ec a app y:
11HVAC Ll Gas Tank Gas Piping IIn n
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction: �J S Ft. of First Floor: _
Cost of Construction: Aj�� p 0 _ Utilities:'n Sewer Septic
OWNERAESSEE:
Name i D
Address: City: State: --� � _�� State: V
Zip Code: Fax:
Phone No. 4 U-7
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
G+
Lot N o.—La—
Block No.
Windows/Doors
Roof Roof pitch
Building Height:
Name:
Company:.Lc, fkme
Address:
City: n
Zip Code: Fax:
Phone No. -3 � 4 ! j ,`t 97c
E-Mail:
State or County License:: (:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: