HomeMy WebLinkAboutgingrich permit appmit to do the work and installation as indicate:
I certify that no work or 1—a a aon a
St_ Lucie County makes no representationthat iW ure
granting
cipermit
t nirulill es, bylauthorize
ws or and covenit ants that er to maydthe restri subject
prohibit such
which is in conflict with any applicable
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 wdth 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, walks, 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
commencingwork or recordin our Notice of Commencement.
OWNER/ CONTRACTOR AFlFIDVIT: Application is hereby made to obtain a per
11 t' h s commenced prior to the issuance of a permit.
re of Owner/
STATE OF FLORIQ
COUNTY OF 1—ctu
as Agent for Owner
The f�rgoing instrument was acknowledged before me
this day of _ FFc6 - _ I 20'X2 by
(Name of person acknowledging)
(Signature of Notary Public- state of Florida }
Personally Known v
OR Produced Wil MUD09)n
Type of Identification
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DATE
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of Contractor/License Holder
STATE OF FLOR DA
COUNTY OF_� ..�
The forgoing instrument was acknowledged before me
this day ofTEc..& , 20?A by
(Name of person acknowledging } "
{Signature of Notary Public State of Flarida }
Personally Known �OR Produc%i�Iiiion
Type of identification ���•�� $pENOW
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PLANS VEGETATION SEA�i�OR M*V4ROVE
REVIEW REVIEW RI=VI� +ern+in 00IEW
Rev. 7/ZQ14
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
PERMIT APPLICATION FOR:
Address: I!t I
Legal Description
Property Tax I
Site Plan Namf
Project Name:
Setbacks Front
i Ey��� PI-r `e- � -3 L-
k sss�
BaCK: K1gnz Zjiue Lira L .;IUr-.
L Jay/
Mechanical — Gas Tank _ Gas Piping _ Shutters
Electric Plumbing _Sprinklers _ Generator
Total Sq. Ft of Construction: �� Sq. Ft. of First Floor:
O�
Cost of Construction: $ r� S Utilities: Sewer _Septic
0" . NleLES�I
Name Ycivycl c,vL CL N ctJ L-, (-,)r rLc..� rc rr
Address: f f 'S _
State:
City: F t1
Zip Code: 5 % Fax: /j/ --
Phone No. 3, S—". -
E-Mail:
Fill in fee simple Titie Holder on next page ( if different
from the Owner listed above)
Company: f'N t
A aA,... 1 s 11
Windows/Doors
Roof Pitch
Building Height. _ EY -
2
M l;
City: Foy t State:-E—L
Zip Code. 3 `L r�� ' _ Fax:
Phone Na
E-Mai! Grc-li -L�
State or Cou y License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.