HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICA LE INFO Mq6sT BF..,COMPLErEbTOR-APP1=OWtO BE ACCEPTED
Date: ;5 �NNED JUN 2 12015 Permit Number.
f5
Public Works.
o _ St. Lucie County, FL HtJf'
teary 11116 - §(iffe di srl8 ad
Building Permit Applica o�°`w' � ` `�'`� 1'94196)
� hI. L�x�iilE�
Planning and Development Services Bbndiad9h fbt;',ii��:
Building and Code Regulation Division"'-
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 C mmercial Residential _
PERMIT APPLICATION FOR: To Select from
dropbox, click arrow at the end of line
PROPOSED..I- _ PROUEMENT LOCATION
Address: 3
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
9
` Siri-�k —/a ur r
4)' Back: Y/ Right Side
15 1--tle
Left Side:
7(
Lot No. 1_
Block No. �, v
a s6a PsT (� b Qm, d scam Aodol' ��- x l7.
r_ 'he` '.
77-7,31
4V.IVJ'l.I1Vt. � V1Ya,11,y1. vnw�rs, ,v,�.• -
Additional wor� to je ne orme un er t is permit
❑HVAC I =.J Gas Tank ❑Gas Pi
11 Electric 0 Plumbing E]Sprinl
Total Sq. Ft of Construction:
Cost of Construction: $
Ing Shutters 1__._L Windows/Doors
!rs Generator Roof
So. Ft. of First Floor: Y
Utilities: 0Sewer D Septic Building Height': /G �
'CONTRACTOR �, 3 _ E
~Name 22 ci.—
Name:
C
Address: c3 TO 3 %vl
Company: e
.-,..�
City; Q„P-ice State:i�'"E—
Address: C 03 <E
.— 1—
_
Zip Code: ��l /7 Fax:
City:
State: —
,(f/
-72—f
Fax: 7 7 ' V66 �S
Phone No. ' �
Zip CoderC�`
E-Mail: A-l' %/%
Phone No.
Fill in fee simple Title Holder on next page( if different
E-Mail: ceGr
�QC%
from the Owner listed above) I
I
State or Coun License:
If value of construction is $2500 or more, a RECORDED notice or L;ommencememi is requires.
I
O
i
0
SUPPLEMENTAL
' - 7
CONSTRUCTION LIEN LAWINFORMATION
:.:
yr
DESIGNER/ENGINEER:
Not Applicable I
MORTGAGE COMPANY: Not Applicable
Name: h/W rQ
4 p
_
Name:
Address:
orf
Address:
� City:
Stater
City: State:
Zip: 33� (1 Phone: '-? '7--
5;3Y add I
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable I
BONDING COMPANY: _Not Applicable
Name:
_
Name:
Address:
I
Address:
City:
I
city:
Zip: Phone:
Zip: Phone: I
I
I certify that no work or installation has commenced prior I
St. Lucie County makes no representation that is granting a
which is in conflict with any applicable Home Owners Assoc
structure. Please consult with your Home Owners Associati
In consideration of the granting of this requested permit, I i
in accordance with the approved plans, the Florida Building
The following building permit applications are exempt from
accessory structures, swimming pools, fences, walls, signs,
WARNING TO OWNER: Your failure to Record a No
improvements to your property. A Notice of Com
before the first inspection. If you intend to obtain
commencing= work or recording vour Notice of Cc
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The for g instru*nt was acknowledged before me
this ay of ! 20t-'_'by
(Name of person acknowledging)
of NoM Public- State of Florida )
Known OR Produced Identification
ANGELA'M HU j
QFy POlie . State df Florrda
Commisslon # FF 234730
National Notary 'Assn
the issuance of a permit.
!rmit will authorise the permit holder to build the subject structure
:ion rules, bylaws or and covenants that may restrict or prohibit such
and review your deed for any restrictions which may apply.
hereby agree that I will, in all respects, perform the work
)des and.St Lucie County Amendments.
ndergoing a full concurrency review: room additions,
een rooms and accessory uses to another non-residential use
:e of Commencement may result in your paying twice for
encement must be recorded and posted on the jobsite
nancing, consult with lender or an attorney before
mencemeDt.'?
STATE OF FLORIDA
COUNTY OF Q C1
ing instr ent was acknowledged before me
day of 20 by
(Name of person acknowledging) -
Type
Public- State of Florida)
Known I OR Produced Identification
— EWM HUFF
Notary Public . State of Florida
My Comm. Expires May 27, 2619
Bonded through National Notary Assn.
REVIEWS
FRONT '
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW'
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
I
I -
v