HomeMy WebLinkAbout3202 Juanita Av Permit App (Stucco)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �-/ "�/'Z''
Permit Number:
Application
Building Permit
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:
Legal Description:
Property Tax ID #: O�/C/y�7�
(/L� Lot No.
Site Plan Name:
Block No.
Project Name: C
Setbacks Front Back:
Right Side: Left Side:
Additional work to be performed under this permit — check all that apply:
Mechanical _Gas Tank
T Gas Piping _ Shytters _ Windows/.Doors
Electric Plumbing
_ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ 1 �,r'�• (,�
Utilities: —Sewer —Septic Building Height:
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NamQ COAX612 J��WA•
,,Name:. ,,..,... '
Address: �(.� "�
Company:
City: l 2LE&C,
state: FIL '. Address:
PIERCE, FL. 3494i_-_
Zip Code,: Fax:
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M._:
Phone No.
Zip Code: Fax:
_
E-Mail:� — G-7G/
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Phone No y T���T�! `$
Fill in fee simple Title Holder on next page ( if different E-Mail 5
from the Owner listed above)
State or County Licensee �6/"/ MY
If value of construction is 2S00 or more, a RECORDED Notice of Commencement is required.
M -
DESIGNER/ENGI E .
_ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
Zip: hone
State: City: State:
Zip:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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.
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
rnmm=nrin0.%A1nrk nr rPr6rHino vnur Nntirp of Cnmmpncement. - i9
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Signet r of Owner/ Lessee/Con actor as Agent for Owner
Si a of Contractor Licen Holder
STATE OF FLORIDA
L.vC
S ATE OF FLORIDA j , , C�
COUNTY OF LhJI
COUNTY OF l
The forgoing instrument was acknowledged before me
The forgoing instru ent was acknowledged before me
20� by
this' day of Q. (2r'• k 20 by
this � day of
Lcn�:j a s\,..sA-oy —
LL",A-
(Name of person acknowledging)
"
(Name of person acknowledging )
— cl"-
(Signature of Notary Public- State of Flo a ) •
(Signature of Notary Public- St to of Flo ' a
.
Personally Known OR Produced Identificationy/
Personally Known OR Produced Identification ✓
Type of Identificati
Type of IdentificatiT 0
Produced
Produced
i"e ti �7 v✓� ►{; 'Y •i' RIANARAYA
Commission,N `
4pl�i�Publtc •State of Florida
��Y °� `. (SealDRIANA RAYA
Commission No. 4f
Notary Public -State of Florida
e' -ion N GG 964615
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REVIEWS '
FRONT
PLANS
VEGETATION
r
ZONIN
SUPERVISOR
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. //ZU14