HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 U—�� PerrnitNumber.
� 0—
- �-=. SCAWNEL)
o -
- Building Permit Application BY
St. Lucie Cotint ,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
•PROPOSED IMPROVEMENT:LOCATIpN _-
Address: 1
Legal Description A !au 1hk01 ahu E-k OR F 112 P)Ob PLC) �0%1 �l1U1tb7
PropertyTax(D#: i jJ1 lkI—dDU\--060"CJ Lot No.
Site Plan Name: XG•Y-.CS' �c�� ►> Block No.
:Project Name.
2 5
Setbacks Front _ Back: 1 �J Right Side:' _2 \ Left side:17.
f)ETAILEU DESCRIPTION OFWORK
e b �, hd v 5 iv✓ram d�weEQ >� 'aoyy)
d arn�5-g� 1 Yi � rrn
CONSTRU.CTIOh INFORMATION,
A itiona wo to e e rme urker ispermd-c ec a app r-
EIHVAC [:]Gas ❑ Windows/Doors -
Gas Tank Piping _Shutters
Electric Plumbing OSprinklers Generator Roof
Total Sq. Ft of Construction: Ft. of First Floor. /�
"1 ci
Cost of Const ruction: $ 3 J U V Utilities Sewer Septic Building Height:.
OWNER/LESSEE::. -
CONTRACTOR
Name
Name: to C
-
Address:
Company:
CA,. 1'�i2 State:��
Address: "
City: F-f f Slate:jE
Zip Code: 1 Fax-. AJ
Phone No. Mr) -U5$
Zip code:3t)s -Fax: 27d-C466�Ci%
E-Mail:WA
PhaneNo.
Fill in fee simple Irdlel Holder on next page( if different
E-Mail:
State or Count irpden: -
from the Owner listed above)
If value of construction is $2500 or more, a RECORDWIllatice of Commencement is required.
Name.
Address:
may. State:
Zip: Phone:
FEE SIMPLE TITIE HOLDER: - _ Not Applicable
Address: '
CRY.
Zip: Phone:
MORTGAGE ODMPANY: _ Not Applicable
Name•
Address:
State:
ZFp: Phone:
gOND1NO COMPANY: Not
Name:
Address
lSty: _
Zip: Phone:
I cer ify that not nxit or tastallatlon Eros commenced priortothe lsumm of a permit
structure'.•P1jjjWmnwltwlth your Home Owners Assodation and reviewyour deed for any resmwmns wean Immr aMwr•-
In consideration ofthegrattNng of this requested pem ft 1 do herebµagreethat 1 w , In all respects, perform the work
In accordanoewith the approved plan the Rorlda Building Codbs and N: Lucle County Amendments.
The T, MIngpermitapplicationsareaaemptfromundalloftafullconcnrencyreview:roomadditions,
accesmy3tmetums,swunaftpooL%fe ces,vralls,sWn,wommorLVandacarsoryusestoanadlernon-rsddmft use
WARNINGTO OWNER: Your faihrreto Record a Notice of Commencement may result Inyouraaytngtwice for
impprovements to your property: A Notice of Commencement mast be recorded and posted on the jobsite
hire the first hrsoection. If you intend to obtain financing, consult yl M lender or an attorney before
SrATE OF CCOUNINOLORiDA
Theforgoirtg ntearWasadotow me
this �Qday
7 �
STATEOFFLORIDAI -
000NW( C4%._riQ ----
-rheforg0irrghnb wwaci befioreme
tids1Q,dayof itid 7A�i �1L
(111arrretng orpersonacimowlecI )
Y '�
Person* Known - OR Produced !dentin ation Pem,
Type of Identification Produces TYPe
Commission
Iden
REVIEWS -
FRONT
COUNTER-
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURILE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
nunALS