HomeMy WebLinkAboutBUILDING PERMIT APPLICATION'Alt.APKICABLE INFO.rUST 9 CO, ETED FOR APPLICATION TO BE ACCEPTI,
Date: PermitNumber:
SCANNED (51 ib- ao r vt"?
BY
int
StLucleCol y_.
BUildiiii't)'e'r'-mitAO'plica-tion 4t
Planning and Develop M�ent 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: 1() -3 �5 .1 SE )Lt-AW a 9-,71 fgCol Hi9tz17- Z:� I-, /- UC I in! � L 1 -5 It Illy -21
Legal Description: dfye-A nd RV'' e- Y
Property Tax ID #:
Site Plan Name:
Project'Name:
Setbacks Fr
Mechanical
7—
Back: -2-4> - RightSide:s J, 0 Left Side:,
—;Gas Tank — Gas Piping
— Electric — Plumbing — Sprinklers
Total Sq. Ft of Construction: 44o
Cost of Construction: $ -2 i 000
rA
Shutters
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
IV09
Winclows/Doors.
Roof
Utilities: —Sewer _Septic Building Height: -
r
W-WiNM
we WOas.'
-R'tr
Zip Code: �17 1�(f
Phone No. ( -1-7,Z)
1'e- State:
Fax: J-7.�O 67-T2-
(if cl�i
Fill in fee simple Title Holder on next page ifferent
from the Owner listed above)
E-Mail: 4,.L�W�
-7
�-Jj -i46000OM-17-SkAL
State or County License:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
'X, ..If
whi;I.-I Lei 1:1 imp 0 Ms .4
MORTGAGE COMPANY:
Name:
_KNo t Abpl� le
4WF.1� MUM—
A JWJ
Address:
City:
Zip: Phone:
State:' A
FEE SIMPLE TITLEHOLDER:
Name:
_XNotApplicable
BONDING COMPANY:
Name:
_jNotApplicabie
Address:
Address:
City:
city:
Zip: Phone:
zip, Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permitto do the work and installation as indicated.
,I certify that no work or installation has commenced priorib the issuance of'a permit�
St.LucieCoun makes no representationAhat isgranting a permit will authorize.the permit holder.to build the subject'structure
which is Into %ctwith any applicable Home Owners Amci6tlon'mles, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your dead for any restrictionswhich may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in a11'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 concurrenc: additions,
y review: room
accessory structures, swimming pools, fences, walls, siiris,'s�reen rooms and accessory uses to anoihei non-residential use
I
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improve ts t our property.,4,potice of Commencement must be recorded and'po sitecl-on the jobsite
ot
ander or an attorney before
m n
before the ins u in end to obtain Pnancing, consult with le
S I
Z'vbl
'i�
i 0
commen6 kw6rk r Notice of CcAm'encemen"
Signatur6oftcr%;n�'F/Ag, 1/fessee
Signa—ture -0�1-0-ntractor/License�Holder-
STATE OF
COUNTYOF Lurt-�- 64
STATE OF FLORID�-
COUNTY OF
The forgoing instrumgnt was acknowledged before me
The forgoing instrurnagat was acknowledged before , me
this L7_.day of C7 CLAe-- 20L5 by
this 17 day of, j 2b-LS by
(Name of person acknowledging)
(Name o0erson acknowledging)
(Signature of Notary public- State of Florida
(Signature of Notary Public- State of Florida
Identification
PersonallyKriown OR Produced Identification
Personally Known I'ZOR - Produced
Type' of Identification Pro duced—
Type of Identification Produced
Commission No. NEbRA6MrrHMAX)Co
ission No. N VELASGO
165914
GOWSSION # FF IN
]RES; NovambarZ
914 W # FF
�1.018 'EXPI RM.Nombei2.2618
REVIEWS
FRONT
PLANS
VEGETATIQ
'MANGROVE
ZONING
SUPERVISOR
SEATURTLE
COUNTER
REVIEW
REVIE
IEW
REVIEW
REVIEW
REVIEW
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