HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETE -.-:OR APPLICATION TO BE ACCEPTED
Date: HN Permit Number:
Building Permit Ap
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
PERMIT APPLICATION FOR: Q Od\ �ncldsOf�
PRCIPbS.ED INPRQVE(MENT LOCA110N„p
RECEIVED
licatioW 0 3 2017
Permitting Department
St. Lucie Countar, FL
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Address: Z40 9 T-A V-'� rA, Q-) QD .'C,7>(Z)y"e 'FUr-_r �1 E2GE i eL 14114 9
Legal Description: L.oT 25TQL0CY_ Z - Fe aT Pi-CRCE S -itoRC-S UNIT- 1 -- pl.it-i
Property Tax ID #: 1`13G - (� d 1- 4�s61{ 5 -- (dwj
Lot No.
Site Plan Name: Block No.
Project Name: POOL SG(R W0 1:N GL0CL4 QC rI a ►`'� (Z - T mar go L)oic
Setbacks Front 2.5 Back: 1-0 Right Side: TS i LeftSide: -7-5
aitionai worK to ne pertormea under this permit— cnecK all that apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: IA Zoo Sq. Ft. of First Floor:
Cost of Construction: $ g4000 Utilities: —Sewer --*Septic Building Height:
Name POUAT S .f M K1221 E , il\A
Address: 1400 t R.%V rpro
City: t=0 a;T to `1 mS State: AL
Zip Code: Bagos- Fax:
Phone No. 239--'81 Z —`S3Co 4
E-Mail: babr''kX0. G_ owtlabk. Gobi
Fill in fee simple Title Holder on next page,( if different
from the Owner listed above) `''
Name:
Company:
Address:
City: State:
Zip Code:
Phone Nc
E-Mail
State or County License
Fax:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:.,".,
Address': w s„
City: State:I
.Zip:; Phone
FEE'SIMPLEXITLE HOLDER:, .,Not ApplIicable
Name:
Address:
City: I
Zip: Phone:
MORTGAGE COMPANY: ' ✓ Not Applicable
Name:
Address:
City: State:
Zip: Phone: ,
BONDING COMPANY: ✓ Not Applicable
Name:
Address:
City:
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'[ will, in all respects, perform the work
in accordance with the approved plans, the Florida Bluilding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory struc ures, swimming pools, fences, walls,lsigns, screen rooms and accessory uses to another non-residential use
WARNING OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improveme s to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the i st inspection. If you intend to obtain financing,'consLilt with lender or ari attorney before
commenci work or recording.your Notice' of Commencement.
Signature of Owner/.Lessee/Contractor as Agent f
r Owner
Signature of Contractor/License Holder
STATE OF FLOtIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instr ment was acknowledged befor
me
The forgoing instrument was acknowle ed before me
this'----) day of L, 20_jl by
this day of 0_ by
(Name of person acknowledging)
(Name of person acknowle ing )
(Signature of Notary Pu ic-SStattee off Florida)
(Signature of NZPublic- State of Florida )
Personally Known
Personally KnoOR Produced Identification
R�4>l���Q�
Type of Identifica n,,.ti�a?�.MYCOM��s51ON
20�a
Type of Identifi
Produced '* pIRES.Ueeembe�l6.
�,ldenvrite..
public i
Produced '
Eonded�hN
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
h
MANGROVE
COUNTER
REVIEW
I REV W
REVIEW
REVIEW
REVIEW
REVIEW
DATE
11�I�L
RECEIVED
DATE
COMPLETED
Rev. 7/2014