HomeMy WebLinkAboutAPPLICATION FOR BUILDING PERMITOFFICE USE ONLY,
DATE FILED:. Ot A 6
PLAN REVIEW FEE� I RECEIPT NO.: PERMIT NUMBER:
k�c �E (
CONCURRENCY FEE.'— RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
St. Lucie Coun y Building and Zoning.
2300 Virginia Avenue
Tt. Pier e, FL 34982-5652 Yes
7 2-462-1553
APPLICATION fn r BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
�A_j - _j F%,;, �- %-t� *,,- - � J& r 10_:� r
I., LOCATION/SITE ADDRESS: --w- j,3 40r 7,
2. SAD NAME: SI PLANNAME:
3. PROPERTY TAX ID #:
4. LEGAL DESCRIPTION (attach extra sheets if necessar I y):
5. PLAT 6. PAGE 7. BLOCK 8. LOT
BOOK NO. NO. NO.'
9. PARCEL SIZE: ACRES/SQ FT. LOT IMENSIONS
CkLr
10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
kn�,
�-4 sic)
ll. SETBACKS (ACTUAL) FRONT BACK: RIGHT: LEFT:
SIDE SIDE 72
12. TYPE OF.CONSTRUCTION (Check all appropriate boxes)
I
NEW CONSTRUCTION EXPANSION/ADDITfON INTERIOR RENOVATION
RESIDENTIAL COMM�RCIAL INDUSTRIAL
OTHER(SPECIFY)
13. DESCRIPTION OF PROPOSED USE:
14. Sq. Ft./CONSTRUCTION: 4 Lj I -c, C>-0 V 15. Sq. Ft. Ist Floor: tH 600
-16. VALUE OF CONSTRUCTION: . $
The value of construction is used to determine the amount of permit fees to be assessed� St. Lucie County reserves the right to question and/or modify the indicated
value of construction if it is demonstrated that,the submitted figures are not consistent ith similar types of construction activities. If the value is $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02