HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONName:_
Address:
City:
Zip:
Phone
Not Applica
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: L Q C [3
Address:
City:
Zip: — Phone ` -0
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Address:
Citv:
Zip: Phone:
Not Applicable
State:
_Not Applicable
OWNER CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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, col ult with lender or an attorney before
rnrmm�oi ;nry txlnrir nr rprnrtiina Vniir Nntirp of inrnmenepm t
Si nature of Owner essee/ ntractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
L_ i C('e C6- 1)
STATE OF FLORIDA
COUNTY OF� , li!f Gl �+ rt
COUNTY OF f
The forgoing instrument was acknowledged before me
thisg?D day off) -Ce,e_m�G+`.,ZOZI byPa4,1,.r,,_
The forgoing instrument was acknowledged before me
this��day ofnjee4XlaXA__ 20-2l by `•.
4-Ls (��•� ✓ eC�r
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(Name of person acknowledging)
(Name of person acknowledging)
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(Signature of Notary Public- State of FIONWI 10
only,
(Signature of Notary Public- State of F Y`r' tes
Nnia��z)ation validates
/ signature
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signature only,
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Personally Known
Personally Known OR Produc j
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Type of Identification , ,.. ,d•
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T e of Identification
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commissionF rt ' y y' r3S.i' ^a5n,
No.
� 1 res Jul 28, IOC
rtrt�� 71 searti �s;F,
Commission No. 4.'rdi:•
C nas'
nor'.:..
7jp-?A
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: �:tf U F_ L; f I
Legal Description: 3
A-v,,e_ �
Property Tax ID ;
Site Plan Name:
Project Name:
Setbacks Front Back:
Building Permit Application
Commercial
Right Side:
- �641 e.0 1�_Gd vll r_
Left Side:
Huumunai wurK'(o Qe perrormea unaer finis permjT—cnecK aii inat apply:
_Mechanical — Gas Tank —Gas Piping T Shutters Windows/Doors
Electric — Plumbing _ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: 42
�i C>
Cost of Construction: $ _ _Z ��y
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
f
Building Height: /,�)
�OIT14AGTC3R
Name -t-
Name: ' air_i -t Cr,d4� ~
Address: ��c �r
Company: VI C6. 4nmtx Vm f
City: i State:
Address: , U ci<
City: r State:
Zip Code: Fax:
Phone No. - c� , 3 �-" _
r,�.��
Zip Code. _3 a d Fax:
E-Mail:
Phone No
Fill in fee simple itle Holder on next page ( if different
E-Mail V_ GccVf C�r L
State or Cou y Licensees.
from the Owner listed above)
It value of construction is 2500 or more, a RECORDED Notice of Commencement is required.