HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO UST COW 'rED FOR APPLICATION TO BE ACCEPTE[,
Date: 1 y Permit Number:
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Building Permit Application
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Planning and Development Services 13Y
Building and Code Regulation Division St. Lucie Count y
2300 Virginia Avenue, Fort Pierce FL 34981
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Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: L.iCeV�v` d� d� a k I'la��� wlnla t.L Si+w,vu
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Address: In303 S. .Tv&4 IL�V¢r�r• . F1. Y1erC4 ,��• 3�1q$�
Legal Description:
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Property Tax ID #: 352,E - *701 - ODe4 - 000 - q Lot No.�
Site Plan Name: Block No.
Project Name:
_ Setbacks Front B-7 ' Back: 580 Right Side: y�. �! , Left Side:
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Additional work to be pea orme 4 under tis permit —check all that apply: \
_Mechanical _Gas Tank _Gas Piping _Shutters V Windows/Doors
/Electric ✓Plumbing _Sprinklers _Generator vRoof
Total Sq. Ft of Construction: 2 aq Sq. Ft. of First Floor:
Cost of Construction: $ �S�C�`� a Utilities: _Sewer _ Septic Building Height:
Name L.
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Address:-fl303 S. :[V iA .1 �iwar�r.
City: r4. P.4-�cx State:l;�.
Zip Code: 3 Yq 92 Fax:
Phone No. 77a 33L-74Y i7-1 979- 40,S
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E-Mail: Qzm-rA44. M*,
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Fill in fee simple Title Holder on next page (if different
from
the Owner listed above)
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If value of construction is 2500 or more, a RECORDED Notice of Co
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Not • ' •licable
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FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
iSONDING COMPANY: —Not Applicable
Name:
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Addre
City:
City:
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OWNER/ CONTRACTOWAFFIDVIT: 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 Counttyy 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 coSenantsthat may'restrict of 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 Df'this Fequested'perr mit, I do -hereby bgree that I will i'n'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, walls, signs, screen room's 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 the first inspection. If you intend to obtain financing, consult with lender or an.attorney before
commencing work or recordiniz vour Notice of Commencement_
Si ature of Owner/ Agent/ Lessee -
Signature of Contractor/License Holder -
S E O FLORI��Q4
STATE OF FLORIDA
CO NTYOF Ln—� L�_LG'i(2—
COUNTY OF
The forgoing instrp;�ent was acknowledge efore me
this lay of V Jac 20
The forgoing instrument was acknowledged before me
.
this day of . 20_ by
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(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Nota blic-State of Florida )
(Signature of NotaryPublic- State of Florida )
Personally Known OR Produced Identificati I /'
Personally Known OR Produced Identification
Type of Identification —Produced S
Type of Identification Produced
Commissi n;f�i k�: n•v.,-�„ $ea
Commission No. � (Seal)
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EXPIRES. . EE U83530
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REVIEWS
FRONT
ONIL3
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
'MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. //LVl4