HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COYvirLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a �0 aS 3
RECEIVED
r}
FEB I: 9 1011
a ~
Building Permit Applicatiormitting Deaartmentf mi Lune County
Planning and Development Services
Building and Code RegulationiDivision
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fai : (772) 4624578 Commercial Residential
PERMIT APPLICATION FOR: Q \
Address: %`ld
I Descriiptii
17
Property Tax ID #:y W!a J ly �%� r li - Dd — O Lot No.
Site Plan Name: i Block No.
Project Name: C3GEC L l
Setbacks Front . i Back: Right Side: Left Side:
Aaaitional worK t0 De perrc
_Mechanical _
Electric74
_
Total Sq. Ft of Construction:
Cost of Construction: $
Gas Tank
lumbing
Address:L-/"/U /
permit — cnecK a
_ Gas Piping
_ Sprinklers
"NN'r•
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
City: �7` r/��G� state--) /
Zip Code: Fax:
Phone No.,52/4, - DC 7, ?
E-Mail: _
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Company:
Windows/Doors
_ Roof
Building Height:
City: Ifr % if Stater.
Zip Code• .2Fax: L46 —/ U to 3
Phone No A 0
E-Mail D de
State or County License
if value of construction is 2506 or more, a RECORDED Notice of Commencement is required.
DESIGN /ENGINEER: _ Not Applicable
Name: Z�4 /4vP-ems/11-�
Add reqs�
City: State:
Zip: P one
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: I —State:
Zip: Phone:
BONDING COMPANY: ! _Not Applicable
Name:
Address:
City:
Zip: Phone: -
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: i
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrictorprohibit such
structure. Please consult with your -Home Owners Association and review your deed for any restriction's 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
.. ..1... .....Jinn vn11r Alntirn of rnmmanrpmPnt_ _ I w
commencer woi VI I CI.VI U111 0%A IYVLIVV V
- -
r:ev
Signature of Owner/ Agent/ Lessee/Contractor
Signature of Cont ctor/Licens Holder
I
STATE OF FLO I //,
�(�
STATE OF FLORIDG�
COUNTY OF
COUNTY OF J
I
The going instrul t was acknowledged before me
The fo oing instr "en as acknowledged efore me
day •' 20A./
this day of 20 by
this of
NN 91e erson ac wledging)
(Nam son ac owledging)
i i
!
(Sig tune of a ublic- Stateiof Florida )
(Si nature f Nota Public- State of Florida)
Personally Know' n� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification ' ZPRY pUg SHERRI FEHLMAN
Type of Identification
Produced
Produced _,., �i �. Commission#GG187160
, >. March 14, 2022
O
-F1�I�RbFENLh� ^.1
i �, Edon#GC 160
No. x� �S�
SPExlpim
Commission.No. y��OFF` (u�lClhuB�dgetNotaryServices
Commission
�2
.'
• I 6. 'ced Titia1��eft�,; ,:. icea
I
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
i
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
1
COMPLETED
Rev. 7/ZU14
l