HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONH::,JJTIEdHi
Permit Number:
,i#!lif ff lw,,iy1j,:,,',,uirdinspermitApprication
Phone: (llz) caz_is5\''''",u t'L 349s2
l__ Residentia , t/
Address:
Legal Description:
Property Tax ID #:
Site plan Name:
Project Name:Block No,
Setbacks Front, *n __ Left Side;
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pErmrI - cne
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lGas Piping
applva
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Gas Tank
Plumbing
S prin klers E
S h utte rs
Generator
[_l *,noo*s/Doors
InoorTotal Sq, Ft of Construction:Sq.-[! of First Floor:
utilities: I Ir"*". Er"*
Cost of Construction: S
Building Height:
:
DETAILED DESCRIPTION OF WORI
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PERM'T APPLICAXON FOR:
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90l)t:TRUcTloN I N FoRMAIor\t :
OWNER/LESSE*
CONTRACTOR:
zio code: !&1Xf- Fax:,
PhoneNo.t*(,,t1 - (0Q 2.. ',
Fill in fee simple Title Holder on next O*" t ,, differentfrom the Owner ilsted above)
zip Code'l}
Phone No.'i
state or County Lic"nref,ffir.11i3:,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _-NofEppilcaIle
Name:
Address:
State:
Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:State:Zip:_ Phone :-
FEE SIMPLE TITtE !-|OLDER: _ Not Applicable
Name:
Address:
City: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 inrtrllrtion ,, indi.ril
I certify that no work or installation has commenced prior to the issuance of a permit,
St' Lucie Countv makes no representation that is grantlng a permit will a,uthorize the permit holderto build the subiect structurewhich is in conflict with any,gPPllcabre Hon;6wners As5ociation rutes,-61iii"ws 6r';;{;bviihlXtr tt,at mav restrict cjr prohibit suchstructure. Please consult With riour nome owrieis Alib;iat'ro,?i;nij're;i6fi'),;iii #.1i'ioilni'F"LTri:ii6;, i,)di;"h"il:yidpV
ln consideration of the granting of this requested.permit, I do hereby agree that I will, in all respects, perform the workin accordance with the approved plans, the Florida Building Codes and 5t. tucie county amenJinents.
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 usesto another non-residential use..WARNING TO O}YNER: YOUR FAILURE TO RECORD A NOTICE OF COIIIMEIUCEMENT friAY RESULT IN YOUR PAYINGTWICE FOR IMPROYEMENTS TO YOUR PROPERTV. A NOTICE OF COMMENCE}IENT iIUST BE RECORDED ANDPOSTED ON TllE JOB SITE BEFORE THE FIRST INSPECTTON. tF you INTEND TO OBTAIN FINANCING, COII5ULTWITH YOUR-LEI}IDER OR Ail +rTORluEY BEFORq RECOBD|IUG YOUR ttpTtcqOF CAmitENCEMEtuT.,,
'actor as Agent for Owner
STATE OF FTORIDA
couNrY oF ei\ .[ \)aie
Type of ldentification
ature of Notary
ZONING
REVIEW
Name of person m
Si!-hE-fu re of Contractor/License Holder
STATE OF FTORIDA ,
couNrY oF B\-.Lue\e
Produced
of Notary Public- State
Name of person rpakJnlltateinent,
Type of ldentification
Personally Known -d-produced ldentification
commission Nro. Q G 4 g.@?S* 1S.afy
FRONT
COUNTER
SUPERVISOR
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
RECEIVED
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