HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-All APPLICABLE INFO MUST BE COMI. AED FOR APPLICATION TO BE ACCEPTED
Date: j/h I b LI Permit Number:
SCANNED
BY
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St. Lucie County
Building Permit Application
Planning and Development 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: LJwfer- PPP-14-ef- r,.aneo_ O(n-
Address:
Legal Description:
Property Tax ID #: / L/ - OdS ` 0 II 6 - 000 -7 Lot No. '
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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_Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 136.06
—Gas Piping
_ Sprinklers
/
_Shutters - ' —Windows/Doors
Generator _ Roof
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
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Fill in fee simple Title Holder on next page (if different
from •
or County,
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE •
Name:
•••Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: —NotApplicable
Name:
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City:
city:
Zip: Phone:
Zip: 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 tq obtain financing, consult with lender or an attorney before
commencidwork or recording vour N6tibe of Commencement. I
Signature
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this n_ day of l 20 M by this _M day of 1 �f 2011:1 by
of person acknowledging) (Name of person acknowledging )
`:ure of Notary Public -State Florida) • atu a of Notary Public- State &Florida )
Personally -Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
SHAHNAINGHAM ,4 f ,,,,
Commission No. Tlu '•',.{�} ( 96MISSION#EE050 Commission No. .-l+• (Se }S�HNA INGRAIA
EXPIRES: December 20. 2014 ;_ *� MY NMISSIO I I EE050558
W Bonded Thm Wary,PublIc Undeffille ,'.,•.•, n'-`-` EXPIRES: December20, 2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURT7MREVIEW
ANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED