HomeMy WebLinkAbout703 Splain appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7iL 21 Permit Number:
Budding Permit Application
Planning andDeve*mentServices _
Building and Cape.ReguipHon Divrslon -
2300 Virginia Avenue, Fort 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: a g 56 $
Legal Description: Z 9 3 to 'f" �A a5 w t,a ob- Scx. law w. ' -h
S 9q 4- 6w a-PIX- a-% fk� Fit A--, 5 Z.3 32 to 6 Ale Ee.y a(.• IF, N'(7• fa'-6 Pka
Property Tax ID #: 3S2-q > Z 23 . 00 07- -Ooo •Z Lot No.
Site Plan Name: -4 Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
NNW
MINOR
Aciditionaiworktope rm un r this permit— cneac aji aPA -
OHVAC Gas Tank ❑Gas Piping 19windows/Doors
_Shutters
❑:Electric D Plumbing Sprinklers o Generator Roof Roof pitch
Total Sq.. Ft of Construction: ' FtFt} of First Floor:
Height..
Cost of ConstLuctiom..$ y2 -� �o Util""sties: L--Sewer septic Building
+
Name�T".v �D IOc•� ..
Narriec PerACai�a'HI- ....
4�9 S S ? tv •o:�,. .w- 1�Company-
Lowe's Hbme Ce sters;J1C
Address:
Address: P_O-E oax' 'SW
jState:
city'.
C state: FL
Zsq{ode �J�_Z, F
city:
7 14?q _ 7 �j'O
Zip Code: 32878 1993 Fax:
Phone No.
PhoneNc_ 772,LAO-A(O95-
E-Mail:
FiII in fee simple Title Holder on next_ page (if different
E-Mail: --r P
from the Owner listed above)
5tate.or Courty License: CGC15D8417
if value of coMeructioo is $25W ormore, a RECORDED:Notice of Commencement isrewiked.
Name_..-,, ,
Address::", Lr. ,,.,.. ,. .. .
City State:
Zip- Phone:..
FEE SIMPLE TITLEHOLDER: . VL_ Not Applicable
Name: _
Address:
City:
Zip: Phone:
COMPANY: )L Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Name:
Address:
COMPANY:
Phone:
Applicable
I certify that no work or installation has commenced prior to the issuance of a permit -
St, Lucie Counttyy 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 renew 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. Ludel,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 m esult in your paying twice for
improvements to your property. A Notice of Commencement must be r card d and po don the jobsite .
before the first inspection/ffWu intend to obtain financing, consult wi len r or atto ey before
Signature of
STATE OF
COUNTY
Theforgo',
this
Pew. caf -0 I
Personally.
Type of I&
Commission No.
Revised 07/15/2014
was acknowledged before me
%I-- 201k—by
OR Produced
Notary I
Kati M
STATE
this
Pe A
nstruAnent was acknowledged before me
of kiwi L , 20 u by
Personally Known X OR Produced Identification
Type of Identification Produced
647 Commission No.
11
No>ary.l(e 6W0fAnida
Karl M Rra6aboni
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS