HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLI CABLE INFO MUST ESE COMPLETED FOR APPLICAT1ON TO 13E ACCEPTED
Date:
7�6�1-r
L Q R I L7 ik
Permit Number -
Building Permit Application
Plan nFng and DEveioprnenr Servrce-s
80cring .0'-nd Code Regulation vivision
2300 WrOnici Avenue, fort Pierce Ft 34982
Phone: (77 2) 4 62 - 15.53 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To 9ellert from dropbox, click arrow at the end of lime
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax 10 #',
,SCE_
Site Plan Name, —
PToject Name: �Y �
Setbacks Front Beck;
Right Side;
Left SfdeL
Lot Flo_
Block Na.
-
DETAILED DESCRIPTION OF WORK: III
a3k-c� 1:5V nn? M e
'+0'\ Rook,
CONSTRUCTION INFORMATION-
ACIahzion3l. worlcto rrormea uncerinis permir - cnec
�HVAC Gas Tank Lcias Piping
Electric Plumbing []Sprinklers
all apply:
Shutters
Generator
Total5q. rt of Construction: 5 . Ft. of First Floor:
Cost of C0nstruCA! n-. 1 � � � � Utilities: Sewer 11
O N E R/LESS E E F
game_
Add Tess:
City:
'-i -
Zip Code: Fax:
Fh-one No. - CO - L..I �
State: f
Fill I i n fee si m p le Tit le Rol d er on rti�xt pag e ( i f d iffe rertt
from the owner listed above)
CONTRALTO R:
Name:
Comp -any;
r
Win s/Doors
Pouf Roof pitch
Building Height: ,.
Addre55: - I
7-ip Code: / V Fax:
Phone No, -7r -
State of County License,,
if vaI► p of ranstrue#lon 15 $25Q0 or rnore, o RECORDED Notice of E-ornrnerwcement is required_
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER,
of Applicable
Narne;
Address. -
City: T State.
zip- _ phone_
FEE SIMPLE TITLE HOLDER; � Not Applicable
Name:
Address --
City'.
Zip, Phone:
MoftTGA L COMPANY: Not Applicable
Name:
Addre5;
city; State:
Zip: phone;
BONDING COMPANY; Llet Applicable
Name:
Address:
City,
Zip; Phone -
Ow NER/ CONTRACTOR AFFIDVIT' : Appli-Cation;s herteby made to obtain a permit to do the work and installation as indicated,
1 certify that no work or installation has commenced prior to the is8uance of ;� perm ik.
5t. Lucie C-a u n ty makes no representation that is Sranting a permit wiQ authorize the permit holder to b0d the sub] e :Structure
which i5 in contkict with a ny a p p l icab l e H o me Own er5 Assoc atLon rules, bylaws or a n a cove n a n t s th at m a y re st rict or prohibit such
structu re. Pie a se consu It wi th your Mu me Ow n ers Asso ci a tl o n a n d review your d eed f o r a ny re st ricti Q n 5 Wh I ch m ay a IPPIY
I n co n 5ideratl an of the granti tag o f t h i s requested per m it, i d o hereby a g ree that I will, in ail respects, p erform the work
in aCcurdance with the approved pia ns, the 1 Iarida guiiding Codes and St. Lucie County Amendments.
The foil owi n g build i n g p i�rmit a pplications a re Exe rn pt from and ergoing a f u I I cio n curre n car rewi ew; room add itio n s.
acc-essory stru ctures, s wi mm I ng pools, fe n ces, w a CIs, signs., sere e n roo rns and accesso rV u ses to another n o n -rm i d e n k i a I u se
WARllkING TO OWNER: your jai Iure to Record a Notice of Com me n-ceme nt may result in you paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on th-e jobsite
before the first inspection- If you intend to obtain~ financing, consuIt with lender or an attorney before
commencing worlyor recording your Notice of Commencement. .� �
Signature of n e r{ Lessee/f t ntra ctor a s Agent for Owns Pr
STATE O F IF LO RIDA
COUNTY OF
The jfD i ng i n s trurnent.w 3s ackn-owl a dged befo re me
thisday of 200 1 by
dame of person ng statement
Personally Known _ OR Produced Identification
Type of Identification
Produced
T Public- State of Florida
(Sig n at re � eta ry �
C:omm&i o n No- No Cs
Stale a! Florida
KIira$
i MV C-2mmuntm GG 3 906
Exp;ros G3,x. ?2023
REVIEWS I FRONT ZONING
COUNTER REVIE
k OAS' E
RECEIVED
DATE
COMPLETED
Rev-a/2/17
Signature of
�4m
r{Li ce nse H-0 I d or
STATE OF FLORI `
CGUNTYOF ilt UC,-
The f ruing in5tru ent acknowledged before me
th i say of JL 20SP3 by
Name of p
Persona I Iy K nuwn _
Type of I dent iftcatio n
Produced
gnature of Noxary
Cornm&ion Ho -
SUPERVISOR PLANS
REVIEW REVIEW
rn Biking sta :e m ent
oR Produced ident;fication
VEGETATION
REVI E
e of Flo rids
ryr Public, J JJ FW40
Deana M Sia�ella
My Conm';e ion GG 2291CO
r;�jru Ogre 4J2022
51�A TURTLE MANGROVE
REVIEW i REVIEW