HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
ate: Permit Number: � UU
SCANNED
BY
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Building Permit Application iUED
AUG os zole
anning and Development Services
m) ting Department
,rilding and Code Regulation Division PerS . Luc1e County
300 Virginia Avenue, Fort Pierce FL 34982
hone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PrRMIT APPLICATION FOR: Roof
Address: _�
LE gal Description:
S
Pr I perty Tax ID #:
SiL� Plan Name: _
PrI ject Name: _
i
S' tbacks Front
Back: Right Side: Left Side:
c-Ce F 1-
Elm
Lot N o._2A —A?- L
Block No. U—
O A 'i?K �hn9 'r \2 V%- 4• Zq\Qce- )' ,N ,0031 QS Aecdtci
-},� wa e,:. ^►�_r�a1Gl� 1�'- o� dhe rec\ urn d2 r lec� men F LT41 � - 2(l spa I I
itional work to be ertormed under this permit- check all apply:
1HVAC E] Gas Tank []Gas Piping Shutters I..� Windows/Doors
IElectric ❑ Plumbing Sprinklers Generator L�Roof Roof pitch
I Sq. Ft of Construction: 2 .q1-4 o?j 5 . Ft. of First Floor: 2124a
I of Construction: $ �-,&an Utilities:Z Sewer Septic Building Height:
3N ' me i�C:)<`o`�Y )Nr 11 U A(�\S Y U( I ) Name: k^ 1\U1 )( A�
A. dress:�5a'__35 Nw CLQbC CA�Company:
C1i �� L \ State: �� Address: \
iy: -�
2 1 Code: &0 Fax: City: `i+ �\
P;ione No. ��% �� �(o_ S Zip Code:
E -Mail: Phone No.
J
Fi 11 in fee simple Title Holder on next page ( if different E-Mail: tM� It CC
fr' m the Owner listed above) State or County License:
if 19,alue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Fax:
vl / 1 >
State: FL
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Cii' State:
zip: Phone:
P ;
III
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
N il me:
BONDING COMPANY: Not Applicable
Name:
Address:
AEress:
Ci,piy.
City:
Zi'p:
Phone:
Zip: Phone:
that no work or installation has commenced prior to the issuance of a permit.
Stj 'Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
w ich 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 lionsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in iccordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Th'Ilell following building permit applications are exempt from undergoing a full concurrency review: room additions,
aciclessory 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 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
c N mencina work or recording vour Notice of Commencement.
ILI
re of Uwner
ATE OF FLORID
UNTY OF , LvU`2
as Agent for Owner
forgoing instrument was acknowledged before me
day of A, 20 &by
of person acknowledging)
re grNotary Puolic- State of Florida )
finally Known _D41 OR Produced Identification
of Identification Produced
No.
e La A_C4 V ( s
Sign ure of ontractor/License Holder
STATE OF FLORIDA
COUNTY OF 1— J " , (_4 )C-4,9_
The forgoing instrument was acknowledged before me
this day of 20 & by
(Name of person acknowledging )
(Signature of a Publi - State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
(Seal) I Commission No. C
(Seal)
;,.&
, Commission # GG 47625 *_ Commission N GG 47625 "* *'
Revised 07/15/2014 =• M C MV Commission Expires
y COMm1i sion Expires "!lNlHIi1����� November 15. 2020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
Y
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INII+TIALS
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