HomeMy WebLinkAboutBuilding Permit Applicationy
ALL APPLICABLE INFO MUST BE e-U114IPLETED FOR APPLICATION TO BE ACCEPity
Date:
Permit Num
.A lication OCT 14 2017
Building Permit. pp
Planning and Development Services 8�/.
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: To Select from dropbox, click arrow at the end of line
Address: &225- . S n e e4,&J AC ?WS5 %
Legal Description:
Property Tax ID #: Lot No._
Site Plan Name: Block No.
Project Name: 4GUN025cw
1
Setbacks Front I()' Back: -5 Right Side: 0.6 Left Side: 'gg-�
eov5A"l4 A- v-exv C�- yoch *w3ell
CovsTRuc-roNIG1=oRMATiON �a
11
Additional work to e nertormed under this permit- check
all
apply:
E1HVAC
0
Gas Tank . []Gas Piping
Shutters
Windows/Doors 1
Electric ❑ PlumbingSprinklers
_
Generator
Roof
Total Sq. Ft of Construction: /Co
S . Ft. of First Floor:
69-
0Septic
Cost of Construction: $ Utilities:
_
Sewer
Building
Height:
NamF
Addressp 71 BC'1
City., 4 f4State: FL
Zip Code: Cf fry Fax..
Phone No. 7 2-370-0161
E-Mail: 6li,:MvjvZe4 JL,ibC&Aq
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: �J&fA S' l/15t,
Company: 4 .4r-A
Address:
City:/ �U/�% S/lE'! �2 State:
Zip Code: Fax:
Phone No. %%Z- :3 70 —OW
E-Mail: %2 pa?Z$,(/1? - 0-4 i/
State or County License: GGC e)�27,5 3�1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:, Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name __. Name:
Addiess I Address:
City: ' State: l City: State:
Zip: " -Phone: '` I Zip: Phone:
FEE,SIMPLE TITLE HOLDER: s_a Not Applica
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced pr
St. Lucie County makes no representation that is grantir
which is in conflict with any applicable Home Owners As
structure. Please consult with your Home Owners Assoc
In consideration of the granting of this requested permi
in accordance with the approved plans, the Florida Builc
The following building permit applications are exempt fi
accessory structures, swimming pools, fences, walls, sig
WARNING TO OWNER: Your failure to Record a
improvements to your property. A Notice of Cc
before the first inspection. If you intend to obt
commencing work or recording our Notice of
Signature of Owner/ Agent/ Lessee
STATE OF FLORIDA,& _ COUNTY OF
The forgP�o. g instru en w s acknowledge before
this_' da`y of , 20 l7 by
A.
(Name of person
(Signature of�d'otary Public- State of Florida )
Personally Know %/_
Type of Id ntificatio ProduK t0dy K. GATES
o AFL-, Notary Public. State of Florida
Commissi rf " commission# GG 10
My Comm. expires July 1 2021)
Revised 07/15/2014
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
to the issuance of a permit.
_Not Applicable
i a permit will authorize the permit holder to build the subject structure
;ociation rules, bylaws or and covenants that may restrict or prohibit such
Won and review your deed for any restrictions which may apply.
I do hereby agree that I will, in all respects, perform the work
ng Codes and St. Lucie County Amendments.
)m undergoing a full concurrency review: room additions,
s, screen rooms and accessory uses to another non-residential use
Jotice of Commencement may result in your paying twice for
mmencement must be recorded and posted on the jobsite
lin financing, consult with lender or an attorney before
.ommencement.
MIN
Signature Uf Contractor/License Holder
STATE OF FLORIDA �`���G✓��� ,
COUNTY OF
The forgoing instru e s acknowledged before me
this ay of E 2017by
(Name of person Jckn*ledging )
(Signature of'Notary ublic�- State of Florida )
Personally Known "- OR Produced Identification
Type o
�� ,G� KATHY K. GATES
Comm Notary Public,:State of Florida( al)
mmiss 104018
My comm. expires July 17 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS