HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED —7
Date: Permit Number:
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 WrWaiaAvenua� Fart pierce FL M82
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: CIA 0 0 c�,
Legal Description:
Property Tax 1044:
Site Plan Name:
ProJect Name;
Setbacks Front Back:
Right Side: Left Side:
2, 5 rI rsf C.b . `t'hru +-c waW W
it na wor to a rme un ert s permn-c cc a app y:
IVAC �GasTank []Gas Piping Shutters
Electric Plumbing Sprinklers In -Generator
Total Sq. Ft of Construction," 5 . Ft, of First Floor:
`r �T/t
Cost of Construction: $ 5 Utilities:[]Sewer 0Septic
4
City: tjao 0 twi)()Gf _ State:
Zip Code: 5`7� 0 _ Fax:'(. �f`2
Phone No._ _-2)qQj^ Cj jZ1% " .
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value
Of more, a
Name: sR
Company:
Address: _
City:
Zip Code:
Phone No.
E-Mail:_(
State or Ct
Commencement
Lot No.
Block No.
QWindows/Doors
Imo( Roof = Roof pitch
Building Height:
Fax: 315
License: A $ 3�Q)j
Name; rP ----
Address:
City: State:
Zip: = Phone
FEE SIMPLE TITLE HOLDER: Not
AddreI City.
ss:
Zip: �^ Phone:
OWNE
MORTGAGE COMPANY;
Name: Not Applicable
Address:
City. State:
rp: Phone:
BONDING COMPANY: Not
Address:
City:
Zip: � Phone:
R/ CONTRACTOR AFFIDVIT: Application is hereby made to Obtain a permit to do the work and installatio
I certify that no work or Installation has commenced prior to the Issuance of a permit, n as indicated.f
makeg
which In canFlict wilt i anyr apr se
llka t tlHoomheeowsngerstAsscc�at ondrufes authorize
y a, We or anr�covenantsihat build
ay restrict of prohlbh such
structure. Please consult wlttipyour Home Owners Assoclation 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 al, respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucia 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
commencin ork or cord,n our Notice of Commenrrman+
F FLORID
OF "_4
The forgoing instrument was acknowledged before me
this PD day of ual&fe_� 20by
Name ofperso aking statement
Personally Known OR Produced Identification
Type of Identification
CRAIG A. an
MYCOMMISSION
(Signature of Notary Publlo• State
Commission No. (Seal)
REVIEWS FRONT TONING SUPERVISOR
- _ COUNTER REVIEW REVIEW
Lev.
O 'FLORIDA
The forgoing Instrument was acknowledged before me
thiRB5 day of 0 _r ,"_,20-L) by
Name of persop makings
Personally Known OR Produced Identification
Type of Identification
CRAIG A. an
My COMMISSION
m,Eanacufe or Notary Publ(c-State m7tarr�a601�
Commission No. (Seal)
PLANS VEGETATION SEA TURTLE.TMANGROVE
REVIEW REVIEW REVIEW EVIEW
Wr.CA M1,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and DeveloPmentservlces Building Permit Application
Building and Code Regulation bivis/on
2300 WrginioAvenue, Fort Pierce FL 34982 `
Phone:(77z)462-1553 Fa:o(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line
Address:
Legal De
Property Tax ID M.
Site Plan Name:
ProJect Name:
Setbacks Front Back: Right Side:
Left Side:
Lot No.
Block No.
UU /!!2Q f8-y- l r' c Y'6 Ctdn `GL( C
,?, 6- Arn rl(,sf (D• fhru fG, wait G�aC i�r wilts l�Ze n
Gas Tank UGas Piping U Shutters
Plumbing LJSprinklers UGenerator
Total Sq. Ft of Construction-� S . FL of First Floor:
Cost of Construction: $ `TLi/IJ.'a Utilities -Ins, r[]Septic
Neme � 4'�f^f� a . — _
Name:
Address: 06 S C4,
Company;
n4wDDG( _ State:
Zip Code: MD— Z'I Fax: - Z-7�
Address:
�
CW
Phone No.^ S
Zip Code:,
E-Mail; CS(}1/)b1Vig( CISYN[ypC
i1P�
Phone No,
All In fee mpie Ti—tie Holder on next page ( If different
E-Mail:
from the Owner listed above)
__�
State or d
more,
awindnws,Doors
n
I ! Roof = Roof Pitch
Building Height
Fax:
1WffW
; 1, '1�_
WO
Name'
Addresr
City: State:
Zip: Phone
FEE SIMPLE MU HOLDER: i Not Applicable
Name:
Address:
City:
ZIP: Phone:
MORTGAGE COMPANY: Name: Not Applicable
Address•
City: State•
Zip: Phone:
a+rrurrru wrvtpgNY:
Name: ,Not Appl)cable
N
Address:
City:
DP• Phone•
OWNER/ CONTRACTOR AFFID% I I: Application is hereby made to obtain a permit to do the work and installation as Indicated.
I certffy that no work or installation has commenced prior to the issuance of permit.
St. Ic cie Count% make�no repre entatlon that is granting a permit mill authorize thegermk holder to build the subject strutture
struicturc�Peaftselconsultany
itlary y�HlomeOw^ers Asers sociationour n covenants thatr any
aorprohibitsuch
In consideration of the granting of this n'aV aPPIY•
m accordance with the a requested permit, I do hereby agree that I will, in all respects, perform the work
approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fallowing building permit applications are exempt from undergoing full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-resldentlal use
WARNING nt OWNER Your failure to Record a N*Uce 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
corn men dnMork oCtgcording your Notice of Commenr mn + _
FLORID
OF
"hefmguing Instrument was acknowledged before me
this
,�o day of Q PO by
Name of persorymaking statement
Personally Known _ a/ OR Produced identification
Type of Identification
CRAM A. ORI
MyCOMMU"
(Signature of Notary PublIc-
Commission No. (mil)
REVIEWS I FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
r FLORIDA
OF W. Lac9,�
The forgoing Instrument was acknowledged before me
th-,S is day of r 26 by
Name of vn. o makingsmrement
Personally Known OR Produced Identification
Type of Identificatfon
L"411+w1e oT notary Publlc- State %ffi�'-'��
Commission No. (Seal)
PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW