HomeMy WebLinkAboutMorgan Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�IIII�
Building Permit Application
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 ate/
PERMIT APPLICATION FOR:
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description: LstK�! �J®csal1 �11q�Gc tl�d at p�C�P� l�� [�ai 0�1
Property Tax ID #: 1-76A - �-q Lot No.
Site Plan Name: Block No. // 3-7
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I,JSIWC-- /`/(e' 01" G' (A-t-�- 20-ly.4c--i,f rya1?i-1 (i 5-' 4-Jf
&AU'(0045 1AJ,5-24t-(- Ca` S f Ce4,4i,',,,U#v— ®aJ ?Z!A
CONSTRUCTION INFORMATION:
Additional wor to�pe�m- e un er t His permit-- c�ie-, aTF at app
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
a
Total Sq. Ft of Construction: '`2-"L(,
Cost of Construction: $
Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name /o ,1 t-,,L6 G AA,1
Name:
05�"Af c-
Address:_(,,=,SO'3 `Da)JC-oRJ e -0
Company:
f=-5,jc6-n Ixi c_,L
City: r64--r -'(6-aC6—State: ��
Zip Code: 3 `-l� S�d� o Fax:
Phone No.')"12 - (e13cl - Gj i®2d
Address:
ZZ�('3
City:?®A'
Zip Code:
Phone No
sr &actc- State:
?q5J-3 Fax:
L(-I17
E-Mail: M0"AhJ-Ft_ Qi(, 10 GMA IL, L',,-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail -�LJC-C-01 0 Q^4AIL - Cot--7
State or County
License 3 (zgp'-A
IYGUC VI wiiau uLuvn ib 43UU or more, a KrLUKUru rvouce of commencement is required.
vL,41VFvGR1 _Not Applicable
Name: NMORTGAGE COMPANY: Not Applicable
Address: Address:
City: State: City:
Zip: Phone State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ` Not Applicable BONDING COMPANY: Name: Name: Not Applicable
Address; Address:
City: City:
Zip: PhoneZip: 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
cOmmenc.ixa u.o_rk or recording vni zr Nntira of
ISignature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF_ c�,'_
STATE OF FLORIDA�,.
COUNTY OF F� t
The forgoing instrument was acknowledged before me
this day of -- yr 7 20 r �.
The for ping instrument was acknowledged fore me
this day of �2 �
_
20
(Name of person acknowledging)
(Name of person acknowledging i
(Signature of N ry Public- State Florida)
•.
(Signature of Nota Publi State of Florida ..
i
Personally Known OR Produced Iden i d
4t fRl,r�trt�tl?
1f Sjf iiY FY{�
Personally Known OR Produce
ti,�ati ..; ry
Type of Iden on ;`ti� < • ._<,',
i Produced z� •. iIoduced
> ype of Identification
,• �G ��; 26, 40.E `1:-
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f Commission NO. f$eap
�ko*mission No. (Seal)k�'°
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REVIEWS FRONT ZON �i 6 fl C SQ
VEGETATION SEATUR�PJ
REVIING
COUNTER REVIEW .,~`t,i�F-a t ��$PLANS
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REVIEW REVIEW REVIEW =
DATE
RECEIVED
DATE
COMPLETED
Rev. 7%f'
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