HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
'—� ST. LUCIE COUNTY
PERMIT
PERMIT NO. ` lT ( CODE # )
APPLICATION FOR PERMIT TO CONSTRUCT
JOB LOCATION/ADDRESS:
LEGAL DESCRIPTION 1l 0 p�
ROAD IMPACT: DISTRICT
APPLICATPOr
SEWAGE PERMIT NO.
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PM1 iSoot< Lot F`4tF_ 4L
ZONE
FEE
Q377
S/D 11 n` s s s ll— MAP # FLOOD ZONE\
.rf DRIED ,
LOT _20-4-7 i— BLOCK�— UNIT SEC TWP FQieC5e
PROPERTY TAX ID # 3/�a `� 7 �� �•� n — �'D —
ZONE '-GMPP ' ❑�
Da e
LOT SIZE/DIMENSIONS q OI C o n' EST COST
SET BACKS: FRONT { REAR I I SIDE % �, r SIDE n T
SQ FT BUILDING: LIVING AREA
ARCHITECT: NAME
ACCESSORY +00
CITY
PHONE
ST ZIP
CONTRACTOR:
STATE REG/CERT #
-� C-6 D 9 3 n
COUNTY CERT #
NAME ��� -
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ADDRESS If�tcc
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CITY
STATE_ ZIP L ` -- PHONE3'
OWNER OF
NAME
PROPERTY:
ADDRESS (^ I
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PHONE y �3G U
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CITY T • Q " •e
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STATE � ZIP
STATE OF FLORIDA, COUNTY OF ST. LUCIE Before me, the undersigned authority, personally appeared I C I I It 12 O L I-_
t= 0 lZ who upon
being duly sworn, deposes and says that the information contained in the foregoing ap I' t'On is true and correct.
r
Applicant
Sworn to and subscribec
before me this day of 19 �/ .
SCANNED
SCHOOL IMPACT FEES BY
Required ❑ Yes ❑ No St. Lucie County
Notary dhliJ S tE(•pf F•locid; •at Lp
as a. a Amt. Pd
c• .; ;otg It 9u*!iN ^on {2gat largd
My CoriiritissikiM''t`"'FI ', �:.�CK�e% Date Pd
.3y0)2-0-5 -M117 000 6-
Posted