HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number. I �a-o&as
SCANNED
BY
Building Permit Application St, Lucie CounUCEVED
Planning and Development services
Building and code Regulation Division DEC 11. 2019
23DO Virginia Avenue, Fort pierce FLg4982 I
ing Department
Resid
Phone: (772) 462-1553 Fax: (772) 462-1.578 Commercial ;KPermittLucle Countyential
PERMIT APPLICATION FOR: TQ Select from dropbox, click arrow at the end of line
Address:
M
Legal Description: 09, 3& - 40
-P
Property Tax ID 4:
I .
Site Plan Name:
Project Name:-
i—
Setbacks Front.
rOL-trl J
I
7_
ON S C4
I/z of 5E
I ryl r-^ I 111l o,
L_JNVAC LJ Gas Tank L]Ga
UElectric ❑ Plumbing Sp
Total Sq. Ft of Construction:
Cost of Construc tion: $ !ial a50. 00
i Fi—
Of NC Y4- o4-' rq& Y4_ —
Lot No.
Block No.
Right Slde;,_-_J_0_'LL Left Side. -,� I "7C)
nit - c ec a
Piping Shutters ❑Windows/Doors
rilders ElGenerator Roof Roof pitch
S Ft Of First Floor:
Utilities:11 Sewer EiSeptic Building Height:
City: State: r--L.
Zip Code: -3 8) Fax:
Phone No.-"7 - aDl- 7/bZ
E-Mail: i
Fill in fee simple Title Holder on next page (if different
from the owner Listed above)
is $2500 or more, a -RECORDED Not -ice
Name: V
Company:
Address:
M
�'State: r�z_
Zip Code: 34,7g I
Fax:
PhoneNo. 77.;Z Sol- &;/O
E-Mail: horiz orJ co/ 6 I)e.7t-
State or County License:L�e- 14j R,44
Commencement is required.
City:
Zip: -
FEE
Zip:
OWNER/ C
I certify that
St. Lucie Cour
which is in coi
structure. Pie:
In considerath
in accordance
The following
accessory stru
WARNING 1
before the fit
F
The for oing in
this day o
Name
Personally Knoi
Type of Identifi
Produced_
(Sig ture of Nt
Commission No,
t
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
TITLE HOLDER:
MORTGAGE COMPANY: Not Applicable
Address:
State: � City: State:
Zip: Phone:
Not Applicable BONDING COMPANY: Not Applicable
Name: —
Address:
I Zip: Phone:
ITRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
work or installation has commenced prior to the issuance of a permit.
makes
ct with any applicableiHO a Owners Association ru es authorize
ylaws or anScovenants that mays estrict or prohibit such
consult with your Home Owners Association and review your deed for any restrictions which may apply.
of the granting of this requested permit, I do hereby agree that I will, in all respects,perform the work
th the approved plans, the Florida Building Codes and St. Lucie County Amendments.
icing permit applications are exempt from undergoing a full concurrenty review: room additions,
res, swimming pools, fences, walls, signs, screen roams and accessory uses to another non-residential use
OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
to your property. A Notice of Commencement must be recorded and posted on the jobsite
t inspection. If you intend to obtain financing, consult with lender or an attorney before
Cork or recording your Notice of Comm,.nr•pmonr
------------
ier/ Lessee/Contractor as Agent for Owner Signatur Contractor/License older
RIDAAftu e46 STATE OF FLORIDq,
COUNTY OF
u eyas acknowledged' before me The for oing instru ent was acknowledged before me
L 20LI by this day of t ee 20-1 by
c TV B /To h"67 /h CI4-ekE
Person making statement Name of person
:ion making statement
OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification
Produced
L�it7tC.tOLL.C. �i,��A,y(a,,p ,
ry Pubhc-Stoat �(eNa orida j yhature of Notary Public-St�of Florida )
NbTARYPU IrWafto
A .(fF i:l AAmAwialle Commission No. iv.!id.�dA hurt
FRONT ZONING�SUPERVISOR�PLANS�VEGETATION'S gGTUR��2 MANGROVE
:OUNTER REVIEW REVIEW REVIEW REVIEW
REVIEW REVIEW