HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE.CO1` t,-ETED FORAPPLICATION TO BE ACCEPTER-
Date: _ 6/1(0 Permit Number:
74�4�
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: To Select from, dropbox, click arrow at the end.of line
Address:
Legal Description:
Property Tax ID #: _Arend arcel0130l- Ill -dtol -000 - 5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
nsfullinj 0, VYtJ lolalktr UM on' ldhA' pk ed area rj NilC.
Haaitionai-worx.tooe•pertormed underthis,permit:=check-all-that apply:
HVAC ^ Gas Tank _ Gas Piping _ Shutters
/
±r Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Sq.. Ft, of FirstFloor:
Utilities: _Sewer Septic
wheekhai+-,kr
_ Windows/Doors
Roof RoofPitch
Building Height:
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Name '11IUiri f"J?G�
Name: tJ:o
Address: f ll a. way }' ___ _ -
Company: �4 G � J L ns
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City: _Fr: heytd State:
Address:
Zip Code: Fax:
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State::
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Phone No, l 6
Zip Code: 3 3 / 73 Fax:
E-Mail: '
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Fill:-in'fee.simple Title.Holder on next page'(if different
'ifrom:the Owner listed above)
State, or County L'icense:. (fa
-. Qky. Y1 vvuxP,u%,uun M ?tauu ;or more, a KrCVKUtL) Notice of commencement is requited
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: ,Phone:
!ANY. Not,.Applicable
Name:
Address:
City: state:
Zip: Phone
DING.COMPANY:
Name: _
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior -to the issuance of a permit.
_Not.Applicabie
St. Lucie County makes no representation that -is grantinga 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�prohlbit 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,1.do hereby agree that I will, in all respects, perform the work
in accordance with theapproved 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-mayresult in your paying twicefor
improvements to your property. A Notice of Commencem-e. of mus.`t be recorded ,and.posted on the:jobsite
before -the first�inspectiom if you intend to obtain financing; consult with 1 der or an attorney before
commencine work;af kordine vour Notice of Commencement,.
of
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STATE OF-FLORIDA .a STATE OF FLORIDA, ® d .
COUNTY- OF j�}/Yll -- �Dt<1'i COUNTY OF `'N? /1i111 1 -DA
Theforgoing,instrument was acknowledged before me The r�forging instrument was acknowledgetl:before me —
this
�fJday of j C)IVF 20 ;lby thiso�3 day oft �,,20 a by
(Name of person -acknowledging) (Name of person acknowledging)
(SIgftdturZ of Nota y,P is -State of Florida) (Signatur „ f Notary , ` - State o •Florida )
Personally.Known OR Produced Identification Personally Known OR Produ.cedidentification
Type of Identification Produced Type of.lden'tification Produced
KATHIA CAMACHO &144 ATHIA CAMAChas5 NOTARY PUBLIC
Commission No. (Seao NOTAR RJ6ission No. STATE OF FLORA
STATE F FLORIDA
g a n�� ree�cn� Comm# FF951623
Expires 1119/2020 ,
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA -TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW'
DATE
COMPLETE
INITIALS
41 r.