HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE
EIINFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^�
Permit Number:
Building Permit Application
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:
Address: 3
Legal Description:
Property Tax ID #:��
Site Plan Name: JQri4 NNa
Project Name:
Setbacks Front Back:
RightSlde: Left Side:
_Mechanical AGasTank JGasPi(¢Ing
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_ Electric _ Plumbing _Sprinkl4�9P
Total Sq. Ft of Constructionn:1 d
Cost of Construction: $ _ 3 9% dG
SCANNED
BY
St. Lucie Counhf
Lot No.
Block No.
Windows/Doors
_ Roof
Sewer Septic Building Height:
G ff 11 { 3
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Name g22a C G/� /ABC
Name: `�rrH �icoc%r.
Address:_ 3Y/9a Orw�6Va/w
Company. ��lrrpnr G� r
City: 1051- State:/-'/
Zip Code: 3 Y yl �Z Fax:
Phone No.
Address: -33a/�
City: /z.�T Aete-e State-U2
Zip Code: 3 9j o0a? Fax: 2 2 Z - S93' Joy?f
Phone No. 7267 -633 •07S/G
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: / i o
State or County License: i .i7
IT value or construction is zbuu or more, a xecUHuEu Notice of commencement Is required.
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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 ermit holder to build the subjects ructure
which is in conflict with any applicable Home Owners Assocation rules, bylaws oran9covenants that may restrict or pro ibit 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 I 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 concdrrency 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
im Tents to your property. A Notice of Commencement must be recorded and posted on the jobsite
EEO
fir ection. If you intend to obtain finan , c suit i lender or an attorney before
c men n k' in our Notice of Commen nt
Signatur of Agent/ Lessee
a ure o ntractor/License Holder
STATE O RIDA
STATE FLORIDA
371 L
COUNTY OF
COUNTY OF ati�
The forgoing instrument was acknowledged before me
a
The forgoing Instrument was acknowledged before me
this4dayof�Ax 20�by
thisdayof 20_/I:'Gy
(Name of -person acknowledging)
(Name of person acknowledging
(Sighature of Notary Public -Stet Florida)
(Signat re of� ry Public- State offlorida )
Personally Known OR Produced Identification
Personally Known
Type of Identification cggaw,
I Mlie of Identificatio
MILEY
4AIRI1QL�1
;4APM
Commission No. 7 WM
No.•. �RMR Ji rt®
i
@®1mmission
,. FJIPIRE9 July 18. 2018
a1sN
Raseorss FAVISHOU114afft�1
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014