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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) Date. �) c� Pernit Nu -:- �D�(O k 51 IT 90 - --- - Building Permit Applin74;Ce�ja��= FEB 21 202.0 Planningand Development Services P 'Buildingand Code Regulation Division tai`I"i'i i� " e 9 Ltl l� k , t1. rtirl �11fi 2300 Virginia Avenue,Fort Pierce FL 34982 �,. L.UGi�, CountY L Phone:(772)4621553 Fac(772)462-1578 Coryr erciaiPERI KR, To Select f and opt dick M-C wit the end of line .PROP €D IM PIGT/E[\/ENT LOC`-dTIOM- Address: 12712 NN MarinC CT- YWM 3 990 Legal Description:-6Q 1 a CC — R 0& PropertYTax ID# �4 25 ^(o��" ���"C�L7U' Lot Iib. Site Plan Name: Block i\b, Project Nacre: Setbacks Front Badc Right Side: Left Side: DEf'AI LED DE.SM PTI ON OF 1A.ORIC ?,emD Je axed lrqLacic, I 10.22 x S Cknot qx �©or. a3WMUCn0N 1NI=0WA- ION: AcUtional vvork tou r s penmt— apply. �HUPC _Gas Tank EIGasPiping _Shutters indoor/Doors Electric 0 Plumbing ]SpnrMers E Generator El Roof Total Sq. Ft of Constnution: Ft.of First Floor: , Cast of Cmtructicn:$1,719.�� LfdlitiesSev%e0 Septic Building Height: GM\EF /LESSEE: i C0.'7M�RA fQR Name 2 Nacre: Dak t ctS (It-CJ Adel : 2 12 N oi •n Ct" cor►-a , 0&ft ead Doov 04--we-t Ceast c4 gr �, State: i� Address: 31SS F1 sca_� COwr-1 - Zip Goole. 3 Fb)c Gty. Ri Vi rQ`� State: �i Phone 11 33(v•Q 251 zip code:�3gC-/'1 Fa)c E Nhil: Phone I\b -9-1 Cc Fill in fee situp a Title Holder on next page(if different E IVbil: S SU OVet heaA rC•� from the Owner listed above) State or County License:G K l 2-5 9'Z. If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. &JPRBVENFALGQWMLCfl0N U EN LAW I NFORK/A nON:.... DESIGNER/ENGINEER: �NotApplicable MORTGAGE COMPANY: —NotApplicable Nam: Name: Address: Address: ' city: State: c1ty: State: Zjp: Zip: Phone: FEE SIMPLE TITLE HOLDER: �NotApplicable BONDING COMPANY: Not Applicable Mn-e: Narre: Address: Address: city. Crty 75 P.. Phone: Zip: Phone: I certifythat no%ortcor installation has prior to-the issuance of a permit St Lucie n-does no repr epertation that is grand ng a pe.rmt WI I authorize the permt holder to build the subject stn rtu*e vvivdh is is �ict vuth any applicable�C)Aners Assoaatiai rules,bylaws or and cants that may resU ict or prdhibit such structwe Please consult vuth ynt.r Home OmnersAssociation and reMeroyour deed far any r+estr'ictia-is mNch xray apply. In consideration of the granting of this requested pe nit,I do hereby agree that I Wil,in all res,perfcrrnthe v ork in accordance Wth theapprcved plans,the Florida Building Cocks and St Lude Gounty Arrer cinema. Thefolicmir-gbcildingpemitapplications are exerrptfrom ngafullooncuTencyreview..roornaddrtions, aooessoystructures,sw n-Tnrlgpools,fences,vdls,signs,screen rco and accessory uses toarx)thernon-rEddertial use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for irgxo\xn- nts toyot it property.A Notice of ConTrenceiTent crust be reoorded and posted on the jobsite before thefirst inspection. If you intend to obtain fironcir>€;,consult with lender or an attorney before con-irrienong vwd<or recordi ng VoLr Notice of Coarrenoernent. 2J� �� s e,of Go tesseAgent Signal re-actor/License Holder STATE OFFLORID STATE OF FLO / COUNTY OF �PX M'��r�G> COUNTY OF & G " The f r g i .•, vu3s adz 1o�nie before rre The f 'ng i vuas adgxWedged before me this,��.of 20�by this nof /" 200b by (Narna of person ada)cWeclO rg) (Narre of person ad<ncWecWng) (Signature&Notary Public State of Florida) (Sigrratut of ry Public-State of Florida) PeronallyKia.n v ORPrcduoedldentsficatidn PersonallyK-okra r C Produoedldendficaticn Type of Identification Produced Type of identification Produoad Corrn issicn Nay.,- A> � NNotary Public Stats of Flonde .tom Notary Public State of Flon TracyL Scarlott 'G IN TracyL Scarlott My Commissron'GG 343018 +� < My Commission GG 34301 Revised 07/15/2014 %'Md'F Expires 06/09/2023 q �d Expires 06/09/2023 REM BAS FLIT ZONNG SUPERVISOR PLANS VEGETATION SEATl.WLE N4AkJGPDQPE 00LXVTER REM EW REVIEW REVIEW REVIEW REMEW REME\N DATE COMPLETE INITIALS