HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit 'Number: 0�
SCANNED
BY
St wen Ca viv.
gullid,ing Permit Applicationoe,,
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:
D 14 2- 2 14
LOCATION.:
'A ?�ROPOSED*N16v, 'tMET, 0N
831
Address:
-14L -0
15 T-, L_ U
FL_
23 LJ eg
Legal Description:
LOT- f
110 J3L-C::5r_k,_--
A64 aF_ 9)VL-(L41(�r-7k
11A1IT—
7
Property Tax ID #: -3 0 c044 Lot No.
Site Plan Name: /-,5 /4,i/_-Z- Block No.
Project Name:
Setbacks Front 'z 5 Back: IV /)4 Right Side: Left Side:
� Iff P7 92V,C-'l zfY Vle L
—Mechanical Gas Tank G8 Piping -Shutters
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction: 0 Sq; Ft. of First Floor:
Cost of Construction: $ Utilities: sewer Septic
Windows/Doors
Roof -Pitch
Building Height:
ESEE*�'
"Jow—M
"" " _1 I"R.
T:CCINTTI RA CT,,"
Name
Name:
Address: F1-L A," 1--y
Company:
City: 7/7ei" k? 1— 5' 7-- Ve / 6— State: �(
Address:
City: State:
Zip Code: 7 4Pa"S Fax:
Phone No. yj"�-5
Zip Code: Fax:
E-Mail: if c/A
Phone No
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
L
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _Not Applicable
Name: aEc/VoL ,� ;cs
Name:
Address: 6oS c✓ mew � ✓ I L
Address:'. "
City: _D �e_A-�n State:
City: State:
Zip: Phone
,
Zip: Phone:
FEE SIMPLE TITLE HOLbk: _ Notl, Applicable BONDING COMPANY: _ of Applicable
Name: Name:
Address: Address.
City: City:
Zip: Phone: f 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 herebji 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 e�empt 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 with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Coutr ctor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF
COUNTY OF
was acknowledged bef e- ?•:
The f going instrume *";�:
this day of 20 /&'by r=
The forgoing instrument was acknowledged before me
this day of 20_ by
m<a
(Name of person acknowledging)
a mi
(Name of person acknowledging)
�zx
.fl
(Signature of N ryPubiic-.State of Florida
p
(Signature of Notary Public- State of Florida )
Personally Kno OR Produced Identifica
Type of Identification //
n
Personally Known OR Produced Identification
Type of Identification
Produced
C
,
Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
R KEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
3 "
iev.7/2014