HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE
Date:
ArTED FOR APPLICATION TO BE ACCEPTED
WANNW Permit Number:
I
RECEIVED
Building Permit Application
Planning and Development Services
Building and Code RegVkruon Division
23W WrginiaAvenue, fort Pierce FL 34982-
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: To Select from
JUN 12 7018
Permitting Department
St. Lucie Co
I Residential
click arrow at the end of jine
Address: O
Legal Description•- A . dWomaj
Property Tax ID #: — — . - e O
Site Plan Name: . ' n% Block No.
ProjectName:j.( _Z
.._.�_ Back: `
Setbacks Front 0 �_ Right Side � �— :
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DETAILED'DESCRIPTION OF 1NQRK
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------ ---. .. .. . pv. ....�.. u�1YG� unb paumm -' cneCK au inat apply: -
_ WAC _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers , _ Generator Roof Roof.pitch
Totei.Sq. Ft of Construction: Sp. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer Septic Building Height:
Addres • o . V 4 M fA C77 ..�
City: State• �L
Zip Code: 344 q 0 ` Fax:
Phone'No.
1-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of Consb ucdon Is $25W or more, a RECORDED Notice of
Name:
Company:Ou N'N ' •J e-
Address: (4 t,11 /_A}1zr w Y
City: ,&LJLL Q & TY State:
Tip;Code: A4 g4 o Fax:
Phone No. ;L' z3s
E-Mail: PC�o
State or County License: �� Ll
Is required. .
DESIGNER/ENGINEER —Not Applicable
MORTGAGE COMPANY:' _Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:'
Zip: Phone: I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable-
BONDING COMPANY: _Not,Applicable
Name: T'
Name:
Address: I
Address:
City:
city:
Zip: Phone:
Zip: Phone: I
I,
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do thework 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
which is in conflict with any applicable Home Owners Assoc
structure. Please consult with your Home Owners Assodatii
In consideration of the granting of this requested permit, I c
in accordance with the approved plans, the Florida Building
The following building permit applications are exempt from
accessory structures, swimming pools, fences, walls, sigris,
WARNING TO OWNER: Your failure to Record a Noi
improvements to your property. A Notice of Comi
before the first inspection. If you intend to obtain
commencing work or recording vour Notice of Coi
STATE OF FLORI
c COUNTY OF
The fflflrgoing instrum nt cknowledg efore me
this II day of 20by •'
of person acknowledging)
Personally Known /`,
Type of Identification Prodt
Commission
REVIEWS
DATE
COMI
State of Florida-Nota
(-(rQ mission # GG 1
My Commission E
February 26, 20
armit will authorize the permit holder to build the subjectstrticture
tion rules, bylaws or and covenants. that may restrict or' -prohibit such
i and review your deed for any Testrictionswhich:,may apply:
hereby agree that I will, in al[respects, perform the work
odes and St. Lucie County Amendments.
ndergoing a full concurrency review: loom 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
nancin& consult with lender or an attorney before
mencement.
STATE OF FLORIDAC: -1,
COUNTY OF < R
The f rgoing'instrum cknowledg efore me
thls'� day of 20by. .
(Name of -person adcno ledging )
(Signature of NoYgry P lic._State of Florida )
Personally Known , orpi
Me of Identiflcation Pro .GPI Ala � ate of Florida-Notary Pu
a
FRONT ZONING UPERVISO
PLANS
COUNTER I REVIEW I S REVIEW R I REVIEW
ssion # GG 1902M
W��nission Expires
fttlary 26, 2022
VEGETATION SEA TURTLE I MANGROVE
REVIEW - REVIEW REVIEW