HomeMy WebLinkAboutBuilding PermitAU APPU:ll •rFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED
Date: ::!~ l j ~ I Permit Number: _______ _
COUNTY -....._
t'LORtOA
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart 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
Address: (} (Oil ef[e 3 45"
Legal Description: ,,/
PropertyTaxlD#: Z.~3-2'-ll -001.$,-000/S LotNo .. __ _
Site Plan Name:________________________ Block No. __ _
Project Name: _______________________________ _
Setbacks Front.____ Back: ___ Right Side: ___ Left Side: __ _
DETAil£DOESCRWTION Of WQfU(: ·
1s permlt-c
Gas Tank as Piping
D Plumbing Osprinklers
_Shutters
□Generator
D Windows/Doors
□Roof
Total Sq. Ft of Construction:~------
Cost of Construction: $ ~izoo. OD
51\:-£!; of First Floor:
Utilities: LJ Sewer □Septic Building Height: ___ _
OWNEB/1.ESSEE:
City: 0 State:tk_
Zip Code: 30lA Fax: . ...,.. ______ _
Phone NotwMt: C:WblWl'e,. ~es
E-Mail: 3oq.-{p31.j.-').ol}5'
FIii in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company: P,Pl>j.hWJl.l_ill
Address:5(0 A
City: fofb H'ifc.e., State: Ft-
Zip Code: 3 44 5 l Fax: 71.:Z.-Ltl,~ -.3737
PhoneNo.'.11.l-4<a(-414-I
E-Mail:boyieae IJ.Jj,ahoa-C.ol!1 '
State or County ucenk e.Ac-li lira lJ
If value of mnstruc:tlon is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCilON LIEN l.AW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _.Not Applicable
N am e: ; Name:
Address : Address:
City: Stat e: --City: St ate: --Zip: Phone Zip: Phone:
FEE SIMPLE TITlE HOl.DER: __ Not Applicable BONDING COMPA.'W: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ OONTRAOOR AFRDVIT: Application is hereby made to o btain a permit to do the work a nd installation as indicated.
I certify that n o work o r installation has commenced prio r to the issuance of a permit.
St. Lucie G:runtv makes no representation that is granting a JJs.mit will authome the permit holder tn build the subject structure
• which is in conffict with any ?PJ)ficable Home OWners Association rules, bylaws or and covenants that mav. restrict or prohibit such
structure. Please consult w1tli your Harne Owners Association and review your deed for any restrictions \\ihich may a pply.
in consideratio n of the granting of this requested permit, I do hereby agree that I will, in a ll respects, perform the work
in acx:ordance with the approved plaAS, "the Ronda 8Ul1dingeodes and St. lucie C.ounty Amendments.
Th e following building permit applications a re exempt fro m undergoing a full concurrem:v revjew: room additions,
a ccessory structures, sv-.rinlming pools, fences, walls, signs. screen rooms and acces.."Ofy uses to anothe-non-residential use
WARNING TO OWNER: YGY.Jr failure to R«orti a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and poste d on the jobsite
before the first inspection. if you intend to obtain financing, consult with lender or an attorney before
commencin work or recordin ur Notice of Comme ncement
Signatureowner/ l.5See/Contract~
STATEOFFi.ORIDA ~ t;.,.,'~
COUNTY OF JI • UA-U,i:;,,,
The ~rgoing instrumentwas acknowledged before me
this I~ day of UM:ch . 20.21_ by
-~l!~-Personally Known OR Produced ldentific:utian __ _
Type of Identification
Produce d,__ ________ _
-~$
{Signature of N
Signature of Comractnr/1.icense Holder
STA TE OF FLORIDA St. I , ',.,,,, > COUl\~OF ______ I.M,(.,, __ ,i;;...r ____ _
The,mrgoing mstryq1ent vta5 acknowledged before me
this~ day of _M(fci:'.L • 20 t.J by
M,cwul F. Bo~~
Name of persoo-fuaking stat ment
Personally Known __ V_ 10R Prorlw:ed Identification __ _
Type of Identification
Produced. __________ _
~LK
REVIEWS FRONT ZONING SUPERVISOR: Pl.ANS VEGETATION SEA TURTl.E MANGROVE
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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