HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII.�14tl'AErINFOWSTBE
Planning and Development Services
Building and Code Regulation_ Division_ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Legal Description:
)RAPPLICAMON TO BE ACCEPTC"U'r 01P�
Permit Number:
SCANNEU "
BY RF�jf,
StIudeCounta '611
Building Permit Applicationst,,e//2 41 9 q®10'9
-paw
COUntYen,
Commercial Residential
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Property Tax ID#:_ 3g09-5-05-- cCo9zC--J-6 Lot No. %c)
Site Plan Name: Block No.
Project Name:
e
Setbacks Front 4, 0 5r Back: It. Right Side: iS , S Left Side: IFS S
✓IV) chanical _Gas Tank _Gas Piping _Shutters Windows/Doors
✓,Electric 11umbing _Sprinklers _Generator Roof /
Total Sq. Ft of Construction: C / So Sq. Ft. of First Floor: 3 SG(� 1/
i
Cost of Construction: $ 3C/ I." oC- e) Utilities: Sewer XSeptic Building Height:
Name JK)A-t2 V_CC,_1 Wv-, 11 d!-ti> Name: Kp.J 14+�+, VL'6C J1
Address:_ 13`rS� MAI "N CT Company: � J 1ZAY✓w� p �572vCa'lc
City: �i Uzi t��CG State: j=1 Address:
Zip Code: Fax: City: j"r : �I IcC Stater
o ,
Phone No. ZipCode:
E-Mail: Phone No. i7Z- ZI to-11008 r499 %W-W-0-034?S
Fill in fee simple Title Holder on next page ( if different E-Mail: Z14 e, 35 (1 5_�X , rNcT
from the Owner listed above) State or County License: CgG 13 7_`77_`�3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Name: 'i"k OeLclk - G--
Address: ig%-4 StJ G3: 1vcaE�
City: PSL_ Stater
Zip: 34c?!&1/ Phone: -+_ ?-
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _-
City:
Zip:.
MORTGAGE COMPANY: _ Not Applicable
Name: S(_ (26/-)i
Address:
City: — �T u a tT State: f /
Zip: 3Y9g Phone: Ste- -k) 5991
BONDING COMPANY: _Not Applicable
Name: -
Address: /
City: /
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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 County makes no representation that is granting a permit will authorize the permit holder to build the su bject 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 1 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, walls, sighs, 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 the first inspection. If you intend to obtain financing, consult witI lender or an attorney before
commencing work or recordine vour Notice of Comn� mpnre�a�\
STATE OF FLORIDA-i `
COUNTY OF '31 � )Q t
The forgoing instrument was acknowledged before me
this jC) day of 20-R by
(Name of person acknowledging)
re of Notary Publid State of Flc
Personally Knowr OR Produced Identification
Type of IdentificAQCProduced o BSA
Commission
REVIEWS I FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
=0141�ldii7
Holder
STATE OF FLORIDA. 1 G4
COUNTY OF C w
The forgoing instrument Was acknowledged before me
thIsACL day of�J U 2 010,
by
(Name of person acknowledgMg )
of Notary Publi& State of
Personally Known OR Produced Identification
Type of Identificatio Produced
TJ�
Commission NG3,G I
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PLANS VEGETATION SEA TURTLE IVIANGROVE
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