HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUS EECCO .�^ `�TED FOR APPLICATION TO BE ACCEPTEIu
Date: _ l Permit Number: L OV V
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Alvenue, Fort Pierce FL 34982
Phone: (772) , 62-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address
Legal Descripti
Property Tax ID #:
Site Plan Name:
Project Name:
Building Permit Applicatjg&C.iEVE®
OCT 2 7 2017
Commercial PeWfifRaff pt. Lu ounty, Fi!
A/
Back: I b l Right Side
Mechanical _ Gas Tank _ Gas Piping
,,Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ �i_; D , e9 e--?
Lot No.
Block No.
_ Shutters _ Windows/Doors
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Name Cor-1-
Address: -72,1 c-� A614-�
City: P � -C (ri�P_ State
Zip Code: Fax:
Phone No. 9q,' 3
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: Jz-K2 L f'6LAe4-
Company: ZIL -CFu& ?4K
Address:V-6-9? <J /" c-u 0 6:!�:g
City: AW 'W .cam Stater
Zip Code: Fax:
Fax:
Phone No i7 214, -
E-Mail OTC- CpA-cFu4, Pi u S Q� r. a i. G
State or County License c ?,,-/ q,
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
5 1.KTAV-'R',�TIY GtY�41iir1T\llii� a 0M
&' > .:, ,o____. :-;
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: I State:
City: State:
Zip: PFjone '
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: I
Address:
City: I
City:
Zip: Phone:
Zip: 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 wit�rder or an attorney before
commencingw rl cordin our Notice of Commencement.
Signature O ner/ Lessee/Contractor as Agent for Owner
Sig to of Con ' ense Holder
STATE F FLORIDA
STATE OF FLORIDA `
COUNTY OF \J—Q
COUNTY OF
y
The for instr nt was acknowledg d before me
this �y of �- 20�by
r
The ing instr nt w s acknowledg before me
this day of 20 by
Cff - \_/a cl\
vim. e, r \.l`/
Name of person making statement.
Name of person making statement.
Personally Known OR Pr duced Identification IZ
Personally Known OR Produced dentification
Type of Identificatio I
Type of Identification
Produced 7u
Produced
d0<PRY Pf,%, ANGELA M HUFF
B .
?•_°*�`� Notary Public • State of Florida
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�,°taarP�o�,� ANGELA M HUFF
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(Signature of Id StaterrRWpE3c},Q 27, 2015
(Signatur ., Re�blldToSstf�t��@�i 4,19 0 f
Bonded through National Notary Assn. ,
Commission No.
%'F a°•• MY Comm. Expires May 7, 2Q v '
7q OF Fl°,�• Q P
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Commissio
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
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MANGROVE
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DATE
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DATE
COMPLETED
ev. 812117