HomeMy WebLinkAboutBuilding Permit Application FALLAPPLICANX INFO
MUST BE COMPLETED FOR APPLJCATI®N TO BE AC ICEP?ED
Date: Permit Number. D f y
B din gjPe it pli ation
Planning and DevelvpRientServices
Building and Cgde.Regulan lJivsion' -
.�•_ :. .
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(172)462-ass3 Fax:(M)462-1578 'Commercial vl-,- Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
' 'Address: �� Jam' � �S S f✓'r I ___ _ .
legal Description: �� �rOJ� SAC ( C.JIw•k I.� -
Property Tax ID#: D o0►f, O 00 - ' Lot No.
Site Plan Name: . `a®�� SS II� Block No.
Project Name: I
Setbacks Front' Back: Right Side:__ Left Side:
- ��Iwa—
E '"�—
Y+�Ti-,�i W
men a yo rm under • - ap
-
_
0HVAC Gas Tank Gas Piping _Shin� er; indows/Doors
Q:Electric 11•Plumbing �Sprinkr'ers Generator 1 Hoof Roof pitch
Total Sq..Ft-pf Construction: .Ft of Fi I Floor-
of Consteuction:.$ S iltiredes Saw I Septic Building-Height:,.
Cost _
ZR
215
Name Na
iVan3e: PerAcatato'H!
' - Low6%.Horne Centers
Adiftess: Corrapany
Gt Stater A C;ddress: P fix 781 S93.
~ C aiid State* .
Z►pa{ode: 3F9=f Fax:..;, r Ciity_ ��p
+•.> n x !' r 1 r 32878-1993 Fax.
Phone-No_ ~7'� 1 Zip Code: I p
j E-Mail:
Phone NCI �TZ q1 '��4 S
�..` -s Ate•'. �.,,,.
H I I in fee sun09e-title-Holder on next page 4 if&ffere� E=Mail: I�' CGC1Si�417
from the owner listed-alcove) State.or.County Licepse:
if value of constmction,is$2W or rsore,•a gECO :Nc ofr C r is-requ red.
DESlGlVE /ENGlI EER: MORTGAGE COMPANY: ^y of Aplicable
Name.,__ ' . S s Name:
Address::-I'to,?->.a-"-- Ako.c*.*. ;^!4 Address:
City> it.o•eo' State: City: I State:
Zip:� Pane:.. ' Zip: I Phone:
FEE'SIMPLE TITLE HOLDER: . t Applicable BONDING COMPANY: _ Applicable
Name: Name:
Address: Address: 1
City: City:
Ziip: Phone: Zip: 1 Phone:
I
I certify that no-work or installation has commenced prior to the issuance of a pe� it.
St.Lucie County makes no representation that is granting a permit will authorize th' a permit holder to build the subject structure
which is in conflict-with any applicable Home Owners Association rules,bylaws orland 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 con+urrency 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 esult in your paying twice for
improvements to your property.A Notice of Comrnencement roust r ord d and po d on the jobsite .
before the first inspection u intend to obtain financing,consult W_ len r or atto ey before
commencing work or re0rdind your Notice oftornmencement.
Y,_v X s
Sign4OF
r/Lessee/Contractor ecit for Owner Signature o Contractor/License Holder
STAIDA STAVE O ,LORIDA
CO COU O
Therum was acknowledged before me The forgoi nstrument was acknowledged'before nie
this �Mo•� 20Z.1 by thisay of iP'�L�C./ 20 Z� by
Peter PemsA Caram It,
(Name of person acknowledging) (Name of person acknowledging)
igna re o ofary Public--Sta a of Florida) { ignature If otary Public State Flflrida)
Personally K own. x OR Produced Identification Personally Known X OR Produced identification
Type of Identification Type of,Identification•Produced
MarypubrtcSfao:o€f •
Commission No.' ate` K�zn Commissto No. NotarylAeafFtotida
_ FF 7 �(
• � I r Kali M Ri ssidn i
my C+x�cltissiori FF 9$i647
aoa
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE :MANGROVE
-COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE I
COMPLETE
INITIALS 1 '