HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI I
All APPLICABLE INFO MUST BE COMPLETED FOR- APPLICATION TO BE ACCEPTED-�) - a
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Date: •� I Permit Number: 1
MN MWAMPM
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-
PERMIT APPLICATION FOR:
Address: !4
Legal. b '1
Description:
) OAS I
.Property Tax ID #: ��1). 3
Site Plan Name:
Project Name:
Setbacks Front 1 Back:
6J I
M§CM ®� W
No,JIrrft�o-trit��tiulNSt t'y
Additional wor c to be per orme un er
_Mechanical _ Gas Ta
Electric plumb
Total Sq. Ft of Construction: p `
Cost of Construction: $
Name
Address:L} 7 7? 9�
City: Q 0? r le
Zip Code: 3y-q,T 1 Fa;
Phone No. 3 t6 1
E-Mail:
Fill in fee simple Title Holder i
from the Owner listed above)
EN RECEIVED
I ,fig La.AQ°l� (4�19�5[��
Building Permit Applicatio ' MAR 2 0 2018
ST, W0,9 r-04MY, rormnin@
's, Commercial Residential
cS VA �L I
{ p
a'I�� Hof/1 1
Lot No.
Block No.
�s
Right Side: &0__(Y1_,7 Left Side: l
permit— cnecK all tnat apply:
_ Gas Piping _ Shutters
_ Sprinklers ' _ Generator
Sq. Ft. of First Floor:
Utilities: _Sewer --Septic
_ Windows/Doors
Roof
Building Height:
Named b,Q-T i lrL/�1
Company:
Address -
City: 91: 4 1 e eG C_ Stater.
Zip Code: —3 !1C7.9 '-- Fax: L %6 :5 "/ 0 & -3
Phone No 6
E-Mail d
State or County License _
If value of construction is 2500 It more, a RECORDED Notice of Commencement is required. �t4 I ��
' J `I
o
1J t ?
State: El
next page ( if different
DESIGNE /ENGI EER: _ Not Applica
Name:
Address. '7 JJ44
'City: .-J—) State:lJ
Zip:,:Rz�� 9 fQ �.l.. Phone i 6—C."!
.FEE SIMPLE TITLE HOLDER: _ Not Applicable
'Name:
Address:
city:
Zip: Phone:
MORTGAGE COMPANY: — Not'Applicable
Name:
Address:
City: —State:
Zip: Phone'' '
I
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 ado 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 concurrency review: roomadditions,
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'rriust be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
-1menrinn urn rit nr rornrriina vnrlr NntirP of CnmmPn CPm Pnt_
Signature of Ow r/ A ent/ Lessee/ ntractor I
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF \ ? / e,/ �—P p I
COUNTY OF
The forgoing instrument was acknowledged before me
The fo oing ins tr �enwas acknowledg efore me
this day 2gby
this day of-�c , 2048 by
of�f'�-�- .
I
(Na of person acknowledging)
I (Name of nairson acknow dgin )
ture of Notary Pu State of Florida)
ature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification�l
Type of Identification
SHERRIFEH�
Produced (% HERRIFEMMAN
S�YP��
Produced = • mm #GG187160 . .
167160
4',2022
* * arct►14, 2022Commission.No.
Commission No.ryOFF8udD�
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REVIEWS
FRONT
ZONING
SUPERVISOR
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PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
a
RECEIVED
DATE
T_.
i
COMPLETED
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