HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFQ..MUSr BE COMPLETED FOR APPLICATION -TO BE ACCEPTED 7�
Dater Permit Number: X6' — Q
DECEIVE®
_ - SCANNED
Building Permit Applicatiw 2 2 205 BY
Planning and Development Services St. Lucie Count,,
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL34982 St, Lale County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line L
Address: SockC�r�+�—� �dAS7
1 /A
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Legal Description: L-iNCewcoo PAL_ U h i 4- V>- l?Ak-1
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PropertyTaxlD#: 3� c�i5 L�_ J_b�� Lot No.
Site Plan Name: L_ k eW ®C217 `'mot '"� �'� t �Z Block No. LL
Project;Name:
Setbacks Front, Back: Right Side: Left Side:
Any 6.-
Additional wor to e e orme under tispermit=c ec a apply,
_ Shutters ❑ Windows/Doors
OHVAC Gas Tank ❑Gas Piping In
EJElectric 0 Plumbing ❑Sprinklers O Generator Roof
Total Sq. Ft of Construction: So. Ft. of First Floor:
Ob
Cost of Construction: $ Utilities: _ Sewer D Septic Building Height:
Name
Name: 2L
Address: W 71-1vvi
Company:
City; State: r 1
Zip Code: S3%4 SS Fax:
Phone No.
Address: 32W
City: t4 ReYcP State:
ZipCode:34014g Fax: -M-9lS.1 677
Phone No.4.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: �L\P6Ye�'[W1 >���- •�O�
State or County License: r 9- of 5S2 S—
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
00 r�
DESIGNER 113JGINEER
No Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: ✓
Name
Address:
a.,'
Address:
City: f
Stater
City: (
State:
Zip: N4Ca Phone:
Xaib
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: }
Address:
City:
City
Zip: Phone:
Zip: �� Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
ermit holder to build the subject structure
covenants that may restrict or prohibit such
which
or any restrictions 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 concurrency review: room additions,
accessory structures, swimming pools, fences, wags, 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 pwft 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
_ Signature of Owner/ Lessee/Agent
STATE OF FLORlgk
COUNTY OF l� lc% e
The fo oing instrument was acknowledged before me
this day of `V 220�]ISW
1 �tlll"TJl',IEUWI t:ViC �U.vU
(Name of person admowledg7ng )
(Signatwe of94otary Public- State of Florida)
Personalty Known OR Produoedldentification
Type of Identification Produced ��t- l
Commission No. Fr--iDms .Tft N0T DAMS
NOTARY PUBLIC
Revised 07/15/2014
STATE OF FLORIDA Q
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20 _by
of Notary
Known V OR Produced Identification
Type of Identification Produced_
Commission No.s .1o95—=k5
Expires 3/31/2018
CONNIE MC
MaN puhlie ..Cie
My Comm. Expires
Commission I 1
R..e.n n, ,M. u.,:..
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE -
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
_1C
('
COMPLETE
INITIALS
COP
11 Florida
29, 2016
Assn.