HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf�
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PLEPED FORAPPLICA O BE
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St. Lucie County
Building ma I Bill
PlApplecati®n
onningondt)eve%pmentSendaes '
RECEIVED
OCT,3..0 2019
OU/I and CO* Re�ll�+a(,i��.On Ofvkton Permitting Department
_ 2300 Vi ihf rAvenue, Fort Pierce FL3 St. Lucie County
Phone: (M)462-1553 Fax: (m) 462_y57a Commercial
Residential
PERMITAPPLICATlON FOR: To &Iect from dro
click arrovu at fhe end of Jine
Address:
Property Tax ID #: Oa2If'
Site Plan Name:
Setbacks Fiont /O , Back._1O
aw%,L
a5b CAILL. r4
r /-/E-NT&-/2 , (
E ,
WsT.sT c _ (� tJx o9 7t I
Lot N !o, O
Block No. _
tight Side: 10 Left Side: / O
?IE�T %�NIC (t'�4rS
_ .___
AL _ Gas _ G� Shutters _ yyindows
Electric _ Plumbing —Sprinklers � _Generator _ Roo ® Roof pfth
Total 54. Ft of Construction: -
Cost of Construction: $ `��(� .
tJ S9• Ft of First Floor,
_Sewer _Septic Building Height
OWNFR'/I Fccee.
Phone No. M, _ 34 9 -
Fill to feesimpfe Title Holder on next page(if different
from the Owner Bsted above)
L
Company:
Address:
c1tv. Q
Dp Code:
Phone No.
€Mail:
0
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name'
• Name: —
Address: Address:
City:State: City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE FOLDER: _ Not Applicable.
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
F' Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVFT: Application is hereby made to obtain at permit to do the work and installation as indicated.
I.certify that no work or installation.has commenced prloi•to the issuance of a permit
St Lucie Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or andcovenantsthat may restrict
sfiicture. Please
or prohibit such
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 I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St Lucie County Amendments.
Thefoilowing buildingpermit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, 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 with lender or an attorney before
commencing work or recording our Notice of Commencement.
ture gen trsse goat r an re . Tens 6fder
STATE OF FLORIDA STATE OF FLORIDA
•
COUNTY OF_ ST. l [Y' COUNTY OF C�5T, l i(►_
The for ing instrument was acknowled a before me The fo Ding instru ent was acknowledge before me
this day of i�°7[—�j _ _N by this' day of �. 20 M by
i
W \\
(Name of person acknowledging) (Name of person acknowledging)
Q�� r
(Signature of Notary Publlc7S
Xbe of Florida) (Signature of Notary Public- Statt of Florida)
Personally Known x OR Produced Identification Personally Known k OR Produced Identification
Type of IdentiFication Prod c Type of Identification Produ
BRITTANY RE BR DDIN
Commission No ° at oir� Oa -Notary Public "'""
- ss�`io #GG190282 Commission No. �c lorida-Notary 282
'2 GG 190282
2 Comm C6�Yti'Ptf�sion #
- -
My Commission Expires %y,� My Commission Expires
2022 February 26, 2022
REVIEWS FR ZONING SUPERVISOR PLANS -VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW - REVIEW REVIEW REVIEW
DATE,
RECEIVED
a
°
DATE
-
COMPLETED
ev.