HomeMy WebLinkAboutBUILDING PERMIT APPLICATION10-1
Date:
INFO MUST BE COMPLETED FOR APPLICATJON TO BE ACCEPTED
-a 01 Permit Number:
A%�-
RECEIVEDBuilding Permit Application
'
Planning and Development Services OCT -10 -2018
8UJ1dh* and Code Regulation Dl,,&,,,, Permitting Department
2300 Wginla Avenue, Fort plerm FL 34982
Phone: 1 �772) 462-1553 Fax: (772) 462-1578 CDMmerci\a St. Lucie County
I Residential
PERMIT APPLICATION FOR: To Select from dropbox,-
...... dick arrow at the end of line
77 -
0 15MEN Ti ......... ......... M ........... ..... 777 7-777
1, IN M
Address: ebb I Li (..::i I P./ o r, V- i N 7
Legal Description: V, --------------
ij I-
t-aad (a w
Property Ir xJD#:
Site Plan Lot No. Marne:
ame: I
Project Nai ne: Block No.
Setbacks Front Back: Back:Right Side: Left Side...
- - BY
h e, c� St Lucie County
OJ,wJwTVJ%V_ L-.J Gas Tank LJGas Piping UShutters E]Windows/boars "I
Electwic UPlumbing 041 PY
OSprinklers OGenerator C3 Roof 45010 Al
Total Sq. Ft of Construction:
Sq_FL. of First Floor
Cost of Cong 7ucoon: Utilities' USewer QSa
pt,
h, W11"Ai Building Height:
City'.!�
Zip Code:
Phone No.
�-MWA��
State: JZL
Fax:
Fill In fee slmpfe Tftfe mold" an-011!111t
from the 0"Ier UstW abowa)
value afi:i:1
I " ft $ZSW or -Wwela
50 @
vw1�7111CK/CIV(71iVEER: ____ Not Applicable
Name:
Address:!
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY- _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walis, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the1 first inspection. If you intend to obtain financing, consult with len/lel�or an attorney before
commencing work gMcording your Notice of Commiancpman$
_ signature of Owner/
STATE OF FLORIDA v
COUNTY OF —f ��Ir'r� j� ►' U el
The fo oing,ins met as acknowledged afore me
thi*� day o � 20 %by
)I
laagnature of Notary Public- State of Florida
Personally Kndwn� OR. Produced Identification
Type of Identification Produced
Commission No. NpA ��ilI14RREN
MY COMMISSION # GG149063
Revised 07
STATE OF FLORIQA
COUNTY OF----.�r�/�� �l+/P✓
The fo oing in ment was acknowledged before me
thisO day of (��a �P1/ 20 1f by
rll \ %i.��L
(Name of person acknowledging,) _
(SW breof Note\ry Pc- State of Florida )
Personally Known v OR Produced Identification
Type of Identification Produced
Commission No.
AMANUA'S WARREN
MY COMMISSION # GG1490E
EXPIRES October 08, 2021
REVIEWS FRONT .ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
i COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE REVIEW
COMPLETE
INITIALS