HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-1 1
Ad APPUCA13LE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date:
Permit Number:— Lk -, I ,3 s o
SCANNED
BY
Planning and Development Services - suffid,169feernift Application REMVED
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982 FEB. 15 2018
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential\ Permitting Department
PERMIT APPLICATION FOR: St. Lucie County
. T . 0 Select from dropbox, dick arrow at the end of line
Address: 5h Qd 0a) L
Legal Description:
Property Tax ID #: 5-Q QyZ
Site Plan Name: Lot No, —2Lf—
Project Name: Block No.
Setbacks Front Back:
Bight Side: Left Side:
Sd I a� 1�1 I-1�.i��r�5 �s�PvM
oeMallrj - V,
UHVAC Gas Tank 0 Piping Shutters
OElectric Plumbing Sprinklers
11 Windows/Doors
Total Sq. Ft of Construction: Sprinklers S Generator C] Roof
Cost of Construction.. $ 5:bFt* of First Floor.
Utilities: Sewer Useptic Building Heiht: g
C1ty: —J—
State:
-to %-00a: � 7 --1 J I Fax:
J *17
Phone No. q
E-Mail.
Fill In fee simple Title Molder on next page (if dfffWWd
from the Owner Usted above)
of amstrucftn 6 $ 00 or none, a
Name:--',
Comy. pan
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City: —&Y-C,) State.-J--
Zip Code: z2g-&-� Fax: Z--
Phone No.
E-Mail: 0-FRI C
State or COuntY License:
Notice of 6-x�ence�mwt is
.+wna1rCrt/ClYblfYttR: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: `Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: ____
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
w 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 conwrrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen roams 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 lenAe or an attorney before
commencing work aMecording vour Notice of rnmmo.,�o.. —4.
rJ
_ signature of
STATE OF FLORIDA
COUNTY OF f a n �
The fo oing instrum nt was acknowledged before me
this day of 20 %Zby
t1l r )C I LQ✓fP 1
(Name of person acknowledging)
ignature of Notarl Public- State of Florida )
Personally Knowny OR Produced Identificatio'n,4
Type of Identification Produced L.
�o I y /�UG� ;:w�:;; AMAf
Commission No (g �'
'c MY COMA
Revised 07/15/2014
REVIEWS FRONT I ZONING
COUNTER I REVIEW
INITIALS
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged afore me
this --day of k y l L 20 1by
I
(Name of person acknowledgin .)
(Signature of Notary Public- State of Florida )
Personally Known VOR
Produced IdentificatinTypeofIdentificationPr do
October 08, 2021
MY COrA"ON # GG127865
EXPIRES August 04, 2021
S REVREWOR REVIEW PLANS VREVI WON I SEA REVIEW
EWE I MREVIERIAO/VE