HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll IA ! LICABLE I FO MUST BE COMPLETED 'kOR APPLICATION TO BE ACCEPTED
Dat Permit Number:
MANNED
BY
a ,r
WNl A ✓`emtAlication`1Bur?RIF
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Plan ing and Development Services Cie �paly�
Buil in and Code Regulation Division
230 Virginia Avenue, Fort Pierce FL 34982
Phoe: (772) 462-1553 Fax: (772) 462-1578 Commercial Residen
tial .
jPEIMITAPPLICATIONg— We 1qe
FOR:
czei
I
Ad d re ss: /
U Legal (Description: rW e� 0CS ��� g s
C l 9e
Prd,p linty lax ID #: /J v �4 % - C �� Lot No. 7
Site F, I an Name: Block No.
I
Proje; 1t Name:
Setbi i cks Front Back: _ Right Side: Left Side:
01mm- M___
'
�t�,
®�! tlJ IMM F�,.
I lional won to be pertorme un er t is permit- c ec a t at app y:•
¢ IiMechanical _ gas -Tank _ Gas Piping _ Shutters _ Windows/Doors
�i Electric VPlumbing _Sprinklers _Generator —Roof
Total q. Ft of Construction: / Sq. Ft. of First Floor:
4 q.,
Co t i f Construction: $ 3 O" . no Utilities: _ Sewer —Septic Building Height:
I
NO
f
Na iN ,,; , ,• ;. ' GL /� NameF=,r „'3
/L((/
Ad I e'ss 0 Company Y r, d
Cit /-8�4_1e- State: _ Address: 1
Zipl'�Code: �FaX' City: �%� �' i �G I State:
Ph e No. s Zip Code: Y91 L Fax• -i 6 :5 "/ 0 t0 3 -
E-N aril:
Phone No
II IFill fferent E-Mail D d
fro;n fee simple Title Holder on next page (if dithe Owner listed above) State or County License /
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Not Applicable
Name:
Ad d ress:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
Address: -
City:
Zip: Phone:
MORTGA4t COMPANY: _
Not Applicable
Name:
Address:
City:'
State:
Zip: Phone:
II
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 �iermit holder to build the subject structure
which is in conflict with any applicable Home Owners. Association rules, bylaws or an, covenants that may restrict or prohibit such i
structure. Please consult with your•Home Owners Association and review your deed for any restrictions which ma apply.
i
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 concurrency+'review: room additions,
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 i
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 lender or an attorney before
d%^mMonring wnrit nr recording our Notice of Commencement.
lam"112,
Signature of Owner/ Agent/ L tractor
Signature of Contractor/License Holder
STATE OF FLORIDA
FLOF
COUNTY OF (( C
COUNTOF
Y OF 1 z � .
The fo oing instru ent was acknowledged before me
this day of 261 by
The forgoing instru e'nt as acknowledged before me
this: day of 2� by
P(Name
of person acknowledging)
(Name er n ackno edging
(Si ture of N r} tary Publi State of Florida)
ture of Notary P-0 is -State of Florida) p
Personally Known OR Produced. Identification
iPersonally Known _� OR Produced Ident*ationJ
Type of Identification' '
Type of Identification
Produced �vauB. SHERRIFEHLMAN
Produced arc-MERRI FEHLMAM;
x "`•• �' Commission # GG 187160
*
2°�•''•''B��P Com P GG 187160
Commission,No. * *
Expi s ch14,2022
*
(S"I 's March 14, 2022
Commission No." � `°t �,
'*�oPF�°� lea s"�o�Notansenices
N� °c
9't'OF F�°P\ 6aded ThN Bud9e�►b!srY
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE '
MANGROY E
COUNTER.
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
T
RECEIVED
rI
v
DATE
COMPLETED
a
ev. 2014 `� \