HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COW,, _ I',D FOR APPLICATION TO BE ACCEPTED "', _ 2 /,
Date: Permit Number: 3 — 0 0Y� UQ
Bui3P,9trnit Application
Planning and Development Services SCANNED + 5�_�
Building and Code Regulation Division y, „ i l'tN3 BY
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie county, FL St. Lucie CQ�p}�
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resldefitlal may_
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address:
Legal Description: Q l`3 \�\L\\ \ �' .i�51 1 i17LIC_) `\) I _)l \ Vi Lat 1,0
L012 -t5l zq- -,-)1
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: Q Q (i(1S \SkC\6 L-0k
Setbacks Front Back: 1TRightSide
Left Side: IVIA
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Windows/Doors
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Electric
Sprinklers
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Roof
Total Sq. Ft of Construction:
S . Ft. of First Floor:
Cost of Construction: $ 5\ ���utilities:Sewer
Septic
Building Height:
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone:
_
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv makes no reoresentation that is erantine a permit will authorize the o
in consideration of the granting of this requested permit, I do hereby agree that Iwill, in all respects, perform the work
in accordance with the approvedplans, 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, 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
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STATE OF FLORIDA ST TE OF FLORIDA
COUNTY OF_T 7�LNp-r t c UNTY OF �;)Nm ��f lclnJ
The forgoing Instrument was acknowledged before me
thisLdayof_re-h 20 [(o-by
(I\atr+C t f,
(Name of parson acknowledging)
Personally Known V
Type of Identification
OR Produced Identification
Qroduce
AV
Commission No.
,(Se01):erv::i;;:w,arf:a•w;
8�,j{gyp+-�_
JOAN A. STORCH
The forgoing instrument was acknowledged before me
this 10tday of 'F'�VD . 20 11-0 by
Personally
Tvoe oflde
L_�
of Notary P4blic-State of Florida )
Notary Public . Sate (floriaa
N Comm. ExpireU 2016
Commission # EE 632351
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