HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 9-28-18ALL APB LICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / 4 0 �. O 3
Date: Permit Number:
•''" RECEIVED
Building Permit Application �.
Plan ni ig and Development Services
Bufldi g and Code Regulation Division permitting Department
2300 rginioAvenue, Fort Pierce FL34982 �F uc;P county
Phon ((7�462-1553 Fax: (772) 462-1578 Commercial Residential
PER 1IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Addres : -5B' Lls C-Qst�- S >I rGe
Legal D'Iscription:,'�Ul� isn a1ti�S n��. 0I n
Prope Tax ID #: Lot No.
Site Pla I Name: C' � C rLrBlock No.
Project Name:
Setbac I Front Back: Right Side: Left Side
AC L�JN Gas Tank / Gas Piping
!ctric 0 Plumbing Sprinklers
Total S Ft of Construction:
Cost of onstruction: $ c2
Shutters Q Windows/Doors
Generator Roof Roof pitch
S . Ft. of First Floor: _
Utilities 'n Sewer a Septic
Building Height:
� w1 w _r �
Name o
Name:` -Such 5 as1�r
Addresi:3,3 1 o' t`� i1-�(
Company: �VAn AQ On c��t �s
City State: EL,
Address: I lo.; 5 • A 00 A r �4
Zip Co e•34C1 51 Fax:
City: Stater
ZipCode:Fax:
Phone o.
E-Mail
Phone No. -7)a-7 ,k I -I 137
Fill in f simple Title Holder on next page (if different
E-Mail:
le
from t e Owner listed above)
State or County License: a 10515
_J
If value of construction is $Z5uu or more, a KCL.UKUCu rvvncC v& wn....c..�o...a..� .� .may......-•
Name:
Addre:
City: _
Zip: _
FEE Sill
Name:
Addre:
City: _
,Zip: _
In cc
in ai
The
STAI
COU
The
this
Type
ne:
— Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
State: City: state:
Zip: Phone:
TITLE HOLDER: — Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
:hat no work or installation has commenced prior to the issuance of a permit..
County makes no representation that is granting a permit will authorize the covenants that build
arestrict thesubject ro rust such
n conflict with any applicable Home Owners Association rules,
bylaws or . Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
eration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
lance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
wing building permit applications are exempt from undergoing a full concurrency review: room additions;
y structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
ING TO OWNER: Your failure to Record a Notice of -Commencement may result in your paying twice for
ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
the first inspection. If you intend to obtain financing, consult with IendeyQr an attorney before
!ncinR work or Vcording Four Notice of Commencement
FLORIDA
OF li�la�71
ing instrument was acknowledged before me
day of ^^ r f . 20 JXby
person
ng )
ire of Notary Public- State of Fionaa
Ily Known _� OR Produced Identification
Identification Produced
OF FLORIDA I'
ry OF /"i'21"i 1
The forgoing instrument was acknowledged before me
this a& day of a �M1oe,c . 20 Al by
7S k M' Qhe\S\ e t—
(Name of person acknowledging)
(Signature of Notary4State of Florida )
Personally Known _ OR Produced Identification
Type of Identification Produced
..'
i No. C 8�8tarY Pg {g Commission No.
V'nu state °{ S{51o� # Go^ picas
=: • c Co h 28
arc
07/15/2014=•;�.,,F.��� M
AI R ROGER Fu8
bii
f i=lorida-NotarY
State o : ',^n # GG 201.31
MY (;O""',.
March
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
REV'
WS
FRONT
COUNTER
ZONING
REVIEW
DATE'S
COM
, LETE
INITI
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