HomeMy WebLinkAboutbuilding Permit ApplicationDESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
STATE OF FLORIDA
Name:
COUNTY OF
Address:
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Address:
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City:
State:
City:
State:
Zip: Phone
(Signature of Notary Public -State of Florida )
Zip: Phone:
Personally Known - OR Produced Identification
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Commission No. al)
Name:
Address:
FRONT
Address:
SUPERVISOR
City:
VEGETATION
City:
MANGROVE
Zip: Phone:
COUNTER
Zip: Phone:
REVIEW
OWNER/ CONTRACTOR AFFIDVIT: 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 following 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 result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
ev.
II SCOTT L DOBBS II
My Commission Expires
September 13, 2022
SCOTT L DOBBS
II My Commission Expircc II
September 13. 202_
Signature Owner/ Lessee/Contracto s gent for Owner
Signature ofntraaor/License Holder
STATE OF FLORIDA 1
COUNTY OF 11411 _I 'ZL
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledg before me
this BLy of 2Q 0 by
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(Name of person acknowledging)
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(Name of person acknowledging) Ti�T
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(Signature of Notary Public -State of Florida)
(Signature of Notary Public -State of Florida )
Personally Known (/ OR Produced Identification
Personally Known - OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Commission No. (Seal)
Commission No. al)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
II SCOTT L DOBBS II
My Commission Expires
September 13, 2022
SCOTT L DOBBS
II My Commission Expircc II
September 13. 202_
All APPLICABLE INFO MU7T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
i
Building Permit Application
Planning 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:
Address: nc r a
3 C 91
Legal Description: Sec e/GZ -
_Con. ail 2 r I YRl
Property Tax ID #: ( 70% ' OO 7? —OGU - 7
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
7 -
Additional
i ono work to be pe Orme un er this permit - check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric_ Plumbing —Sprinklers _ Generator ✓Roof
Y r -2 Pitch
Total Sq. Ft of Construction: 3 aO O Sq. Ft. of First Floor:
Cost of Construction: $ Sd0 C'� Utilities: —Sewer _Septic B�Icilng
r
Heigh
Name u7S At -b" -e 64i 1 XQ6LLC Name: T. &4-e
Address:� Company:Ci&
o State: Address`: C:
City: � C,., &Q LL
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Zip Code: kY q 7 3 Fax:' City: i 91L !2ie , ilk
State:
Phone No. Zip Code: D �Fax:
E -Mail: Phone No % 7,�a -5-Y
Fill in fee simple Title Holder on next page ( if different E -Mail )324k(-1 DC4s J��rr,�'fo
, C orJA
from the Owner listed above) State or County License C C C, C-_S�_��
If value of construction Is 2500 or more, a RECORDED Notice of Commencement is required.