HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll .:
D1
,:. Perm it Number:
`. •
MI
°•
BuildingI ApplicationTlg�
Planning and .-SCANNEDi
Building „and Code. .
0. Virginia Avenue, Fort PferI
f
Pr Residential
Phone: Y T •
+ CO
PERMIT APPLICATION FOR:
l..••-i "'3 �i."'" yv'.:, f'��j.�FTM'gs-s��ys--^.7-y'��— s# ord ,n:_ T`s�^Y;..,• t'+a�+�. '•''
'• 1®' - FFi tk �• i.'i.� * �i`1'''��3•�Y•g�. -c 't.4'...�..J{�-}�� IM )-`i- -h$
0 � �-#i { A ....Se ei R ll� • i� ..-r .G»'%�R_�'1u "w�JF ft T'ba� R.!4= � - S�i�.iuY.yS..vcu`�i
_
/Legal
'. / / / / /
Description: 0y-Q&oIo--
Property.. y I�Id� rLot No.
Plan Name: Block No.
Projectite
Setbacks• -Side:
w. f i� u r ' 1 s�ck�'•'wi�,£rs..Y �'af"'""1 35''i+°''
?��L Q J€C� 1 s 1 sin 9
UWM
1 �
/
'. �C'raiy1.fT F•e ,.�.:n Y'4,�e'+i��'^- �. `s`i�-R „�j �s 1TY.SR•T .��^te"ffi(''1�'i^eV+TM'YiIF
ITdi4.4i !j Y..� t i$`-
F>`�v
„��1 SS' +v4' °,�`, y des` *�.E i '�•`���`_`�"� -�+E.�- � 1�.
M '_•"-.�3 Fss-R ��'r.`�ti�'e�FI'^Z:4i1�'�C�'�'.✓�'k s�! +iu`•@43R�
� l j �, j ,yi"f> 4x ... }fix • . �•�-.•
I 3 �...$r.z�1.b �i„Y,`�i�.P�._sLb`"6w/�ti.tt.-_ .. F..`�:k _1dl
-
�M._
. • '
fN
��4-Sa. '*F..• all�'t{
YJ E? B B 1%ad,ra'.�Y�+1�'ja g J� p�[f-f�'9. +U'zrii.
��:s: ui �.....�C�•i..�rT � �44u�.:�Ym�`.�1^.v.L
.p5,
1
��
�J wix 1�UDESIGN
1 rb
Gi B lip nI Syr/^T�Yk^�ii 1 °G !'i2:'.`"s'h;4�.x#
��a:�is' V�,`-�a�..}�Y�`�`"
:y�.Y •`�,1A^
� ��rsj��,.tl�'..i�a`tn
ER/ENGINEER:
Name:
• Applicable
i MOR
'Name:
I'
I Applicable
•I•
Address:
City:
• PhoneI
State:
City:
State:
FEE SIMPLE TITLE HOLDER:
Name:
• Applicable
BONDING
Name:
Not Applicable
I•
Address:
• Phone:I
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify 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 permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants 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 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
commencing work or rigpording your NoticgL of Commencement.
Signature f Owner/ Lessee/Contractor as A or Owner
Signature of iontractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledge before me
this ay of/� 20�y
The forgoing instrument w acknowledged before me
this LKnday of by
171�e V��
(( JJ /200
p
�I�KQ �lT�//✓
(Name of person acknowledging)
(Name of person acknowledging) v
(Signature of Not Pu lic- State of Florida )
(Signal a of irtary Public- of Florida)
-SState
Personally Known � OR Producedteer>hcotpp_
Type of Identification R
Produced NOTARY PUBLIC
TATE OF FLORIDA
Commission No. T�ea GG048393Commission
xpil as 1/27/2021
Personally Known �OR Produced Identification
Type of Identification y Stephen P. Frederick
Produced <�� NOTARY PUBLIC
STATEOF FLORIDA
No. (�aWGG048393
Wce Expires 1/27/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. //GU14