HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j ?f
Date: % 7 Permit Number: / ` �J�
RE -
Building
Permit Application MAY 2 2 201,
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: Shutter
Legal Description: ctxx_ -
Property Tax ID #: 6-0o2 C,dO ,Z Lot No. 70
Site Plan Name: Block No.
Project Name: f�%e�
Setbacks Front Back
❑ HVAC
❑ Electric
ight Side: Left Side:
I \/] Shutters
❑ Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Name Z
Address:
City: ��� -� `�dc��{-e State:
Zip Code: - Fax:
Phone Phone No. '77,2 — %D�-S/_3y
E-Mail: i�i ►?zc%{.,, ,�i�7i�h�/i»� Gv
S Ft. of First Floor: _
UtilitiestSewer 0Septic
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
❑ Windows/Doors
Building Height:
Name: .e6 4
Company: .J
Address:o7p
City: State:
Zip Code: 3 7 Fax: V 2.) - ��bb !�
Phone No. ;?7-;? - 87S'` �733�-
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
0
0
LEMEN�AL C NST UCT_ I LIEN L tW 1NF Nf
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City: _
Zip:
Phone:
Name:
Address:
State: City:
Zip: Phone:
Not Applicable
BONDING COMPANY:
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
Not Applicable
State:
_Not Applicable
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
I.UIIII IICI II.II IK WUI R UI 1 CLVI U11IV, \/VUI INUIILU UI ',.VI I I I I I C I I I.0 I I ICI II.
�)' - /"O� __ - S
Signature of Owner/Less a/Co tractor as Agent fo wrier Signature of ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �� COUNTY OF��_
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this =day of ,�L 201Zby this % u`day of (�. , 20 / 7 by
(Name of person acknowledgin ) (Name of person acknowledging )
�24 r_,,e:2 -��O_
(Sign ture f Notary ubli State of Florida) / (Sign tur of Notary Publi/State of Florida )
Personally Known OR Produce Identificationy Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produce —
1'p'.,, MOIRA L. LATOS ; .tirv:'ry'4,, MOIRA L. LATOS
Commission No. _? " ' ;:g h. % ON n FF 144434
My Commission No. •,: MYC��
* = EXPIRE: gust 12, 2018
r, EXPIRES. August 12, 2018 : _ o;
N'e a9e' Bonded Thru Notary Public underwriters
%;,e od F q Bonded Thru Notary Publc Unde carters
Revised 07/15/2014
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