HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONII
ICABL
All APP IN F MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit N
SCANNED r.
c t. Lucie CwtyAUG R
Building Permit App i� its •ijing Dopa,tm,nt
Planni g and Development Services St. LUCli✓ County, Fl-
Buildin I, and Code Regulation Division /�
2300 rginia Avenue, Fort Pierce FL 34982
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Phone:! (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PER II IT APPLICATION FOR: `�itiF/I/Yl
Address a/6 SE F91PO VIS7-P- 09 8
Legal D
i n ,J ,f
'scription: l�i;vZ7L��z�' (Nr� f� 7S�
Propert',
Tax ID #: OaG� '4t50�� Lot No.
Site Plari'
11
Name: Block No.
Project
I ame:
Setbacks
Front Back: Right Side: t Left Side:
�'°(�� ci 1 ', "IYIA ION:
itio
al,work to be pertormed under this permit- check,all that apply:
chanical - Gas Tank _Gas Piping _:Shutters =Windows/Doors .
_fVle
E
Ie ctric _ Plumbing _ Sprinklers Generator _ Roof Pitch
I'I
Total Sc
Ft of Construction: Sq. Ft. of First'Floor: .
II 000
Cost of
onstruction: $ Utilities: _ Sewer _ Septic Building Height:
�I
Name
�v I
6 -rV Ct1� MT UPM Wt It
Name:
>
�s:
Addre
Company:
KW7 0 1/NI LUdIp- State:_
Address: /17 Ce�ea.— 17t-re, G .
City:
City: i o^= �r� ��r State: /' C
Zip C
e: 3q7S.3 Fax:
Phone;
No. W ) `c o �w
Zip Code: 71vf Y� Fax:
'� "(WOIV1 70P
E-Mai
Phone No -77a
simple Title Holder on next page ( if different
E-Mail Go ,, -
Fill in
State or County License --
from I
lee
II a Owner listed above)
I
If value
"f construction is 2500 or more, a RECORDED,Notice of Commencement is required.A.
DESIGNER ENGINEER: _ Not Applicable
Name: -
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING, COMPANY: Not Applicable
Name:
Address: III
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 permit holder to build the subject structure
which 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 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 fuII concurrency review: room additions,
accessorystructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use I'
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
commencing work or recording vour Notice of Commencement. a
rATE
e ofOwner2�/ Less - ' ctor�as%Ml entL-ti
natue of�Contracicgnse,Hol er
OF FLO r p STATE OF FL A
COUNTY OF a COUNTY OF
The f r oing instru nt was. acknowledge befo W 2
thisp day of 20' by - SW g
S
(Name of person acknowledging)
6Z 114ax I =—I*&- m--- ",
(Signature of tary Public- State of FI rida )
Personally Known _� OR Produced Identification
Type of Identification
Produced
Commission No. � (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
COUNTER
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
The for oing instr lent was acknowli
this day of
(Name of person acknowledging)
(Signature of Nota ublic- State of Florida )
Personally Known / OR Produced Identification
Type of Identification
Produced
Commission No. (Seal)
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
ev.