HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAHAPPLICABLE INFO MUST BE COMPLE— 'FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
Building Permit Application SCANN6L,
BY
8tLUUe0r,vow%
Commercial ��' Residential
PropertyTaxlD#:BL122--1,3L4-ioo,,03- eloo-A Lot No.—
SitePlanName: =.h�ARL(Ald LL-iL- Block No.
ProjectName: -rkGL T60(L
Setbacks Front Back: _ Right Side: Left Side:
—Mechanical Gas Tank Gas Piping
Electric )(Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cost of. Construction-$ U) . n0 00
L�� S " -/--/ �j L F eAl e-9 -
—Shutters —Windows/Doors
Generator Roof
Sq. Ft. of First Floor:
Utilities: —Sevver _Septic Building Height:
Aciclrem*73-70 S J JC
CifY?:0FA-. ki. Laz�lfi —State: Nei
Zip Code: I-M S 2- Fax: -772. -S9.5-91 9 J
Phone No. 1 -7 2 - -Sr--k S , ot I q 4>
E-Mail: A I I Lo,34rAJop- 0 Re,) I so a, dtd-.
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Cdmpany:OH#O ntm-,
Address: -7bo F/&PX4 04441C &--e
city: Fact AIL-w ef State: rL
Zip Code: Fax:
PhoneNo(-772-) 214,-3-06,3
E-Mail K- & 7- cf 9 7
State or County License C"WIC191
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —NotApplicable
Address:
Zip:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certIfV 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 subject structure
which is In conflict with any applicable Home Owners Association rules, bylaws or angoovenants 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 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 additio ' ns,
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 ey before
commencing work or recording vour Notice of Commencement. f, 02,
51 ature ot Ow�er/ Agent/ Lessee/Contractor
v I
STATE OF FLORIQA q
COLINTYCIF t>+_&�CACI le —
The Ing instrument was acknowledged before me
10
this I rday of Mi-t-L 20AS' by
�' I (\'�' C' C' 0 1 ( I ns
(Name of person acknowledging)
�9_' ea'6' —
(Sid-Rature of Notary Public- State of Florida
Personally Known OR ro Iden&&hre COI 1 11
It .1. ...1.
Type of Identification X "T.
My COMMISSION 0 Fr'.
Produced EXPIRES MaFth 09.,
Commission No.
REVIEWS FRONT ZONING
� COUNTER REVIEW
STATE -OF FLORIDA
COUNTYOF
The forgoing instrument was acknowledged before me
this — day of 20_ by
it r\ &_� C, C 0 k J J ri�
(Name o erson acknowledging)
(Signature of Notary Public- State of Florida
fe nally Known
,s r r
. . . . . . . . . . . . I
of Identification UNOA C COLLINS
io
COMMISSInti N
f9ro ced My
EXPIRES Mallb 09,2019'
ission No.
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SUPERVISOR I 'PLANS VEGETATION SEATURTLE MANGROVE
RWIEW REVIEW � REVIEW I REVIEW I REVIEW