HomeMy WebLinkAboutBuilding Permit Application i
ALL AP ICA LE INFO MUST BE COMPLETED FOR APPUCATI01 4 TO BE ACCEPTED
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Date: Permit Number:'
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wilding Per limit Application j
Plonn' and Development Services l I
Buildin inla nd Code Regulation Division AvenueFort Pierce FC 34
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2300 V , 9sa�� 1
Phone 772)46e-ISS3 Fax:(772)49 .1578 Comrimer ial� Residential
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PERM APPLICATION FOR: Tp Select from dropbo , click arrow at the end of line
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Address: I
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Property ax ID 049511 ` c • Lot No.
Site Plarr ame: I Block No.
Project me.,
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Setbac Front Back: i Flight Side:: Left Side:
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Ton i 5. tf.0 W, I
Itli work obene orme un lent �s permit—c ec.a apply:
HVOC L_IGasTank I❑Gas Piping _Shutters 01Windows/Doors
�Ele tric E Plumbing i loSprinklersGenerator ElRoof I
4Name
Sq. of Construction. S . t.of First'Floor:
f C struction.$ I Utilities: Sewer Septic Building Height;
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Nai le.
Address: r I Cor ipang
CiOC9I Stater :Ad res5•
Zip Code 'Fax�475 Ci
ate:
Phone N . r Zip ode:_ Fax: '
E-Mail: Ph ne No.
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Fill in fee mpleTitle Holder on next p'4e(if different :E- ail;* •
from the caner listed above) :Sta o County License:
If value of nstructlon is$2500 or more,a.!RECORDED Notice of Comniencement is required.
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NGINEER: � ipt Applicable E�TGjGE COMPANY: No Applicable
Dame: MEMO=
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Addres { A dress:
. i State: C : ^, l
State•
Ctty: .. _ -
Zip: Phone: i' Zi Phone: —
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FEE SI Ll:TITLE HOLDER: Nat Applicable B,NDING•COMPANY: r Noir Applicable
-Name: I' N me: }
Addres '' I: A dress,
city: I Ci li
Zip: Phone: Zit Phone: I•
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I certify ° t no work or installation has c6rrimenced prior to the issu (ce of a permit. I
St.Lucie 'un�y makes no representation'.kh�t is grantin al�ermit wil uthorize the ermit holder to build the su 4)ect structure
which is i nfiict with any applicable Koffi Owners As ociation•rule .bylaws or angcovenants that may reskricti r prohibit such
structure lease consult with your Home O ners Association and rev w your deed for.any restrictions which me ;apply.
In consid tion of the granting of this re4i;e ted permit,I do hereby ree that I will,in all respects,perForm the 'ork
in accord `ce'with the approved pians,the iglorida Building, and t.Lucie County Amendments.
The folio i g building permit appiicatlons;arie exempt from undergoinga full concurrency review:room additions,
accesso ructures,swimming pools,feni a,walls,signs,screen mots and accessory uses to another non-resld tial use
WARM TU OWNERS Your#alluret (Record a Notice of Co mencement may result in your payiniwlce for
improv ents to you(property.A Wtice�of Commencem t must be recorded and posted on he jobsite
before t ° first inspection.If you inf end to obtain financin consult with lender or an attorney efore
comme in work or record ' ur Notice of Commence ent.
Signature owner(Agerit/Lessee ' Sig attire of Contractorf Lic se Older
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STATE ; FLORIDA i ST OF FLORIDA
COUNTYF �[ C1: CO NTY OF t�tx
The ,g Inst entw acknowledge' ore me The org Ing instr ye w s acknowledged ef;re me
th" of 20; y this ay of 20 II
(Name o rson a knoiNle ging) ;' (Ne (e of pers n BE no edging)
(Signator, ' f Notary7OR
-State 4U&60 y; (Sig,ature of Notary Public-State f orida)
Personal( nown Produced•idt 't�facation Pers.nallyKnown V OR Produced Iderttif'`:ation
Type of td `tiflcatiori producedTyp lof Identification Produced
Commissi : mom Iii Con "fission NdS.Ca"'i t'4L0 (Seal
CRYSTAL MARIE CRU W
:•: *= MY'COMMiESION0EEII »�
Revise 7/15f2014 ZOtis 1 M •COMMisslolvtCtE 97403
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REVIEW . MONT ZONING SUPERVISOR PL{ 5 VEGETATION
COUNTER.. REVIEW is REVIEW REVf9-W REVIEW REVIEW ! REVIEW-
DATE
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