HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To SIE ACCEPTED
D June 4, P
2015 T
ate: ermit Number:
RECEIVEL.
Building Permit Application JUN.-Al 2015
Planning and Development 5eivices
Building and Code Regulation Divislan
2300 Virginia Avenue,Port Pierce FL 349$2
Phone:(772)462-1553 Fax: (772)462-1578 commercial Residential X
Ri V�F !tl.�,�le,�."ai�:1.1,��,lr-,,--
366 Midway Road Fort Pierce, FL
Address:
Legal Description: RF-PLAT OF PALM GARDENS BLK 2 LOT 3 (0.20 AC) (OR 3747-1890)
Property Tax I D#: 3403-802-0016-000-6 Lot No.2
Site Plan Name: REPLAT OF PALM GARDENS Block No. 2
Project Name:
Setbacks Front Back: Right Side: Left Side:
ELECTRICAL INSPECTION TO RE-ENERGIZE RESIDENCE; POWER OUT OVER (1)YEAR.
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21 -445152K- 2--1 110lj7k-R
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i iona wor e r un e'r this permff=—heck ar apply:
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0HVAC Gas Tank Flas Piping Shutters Windows/Doors
[�IFJectrlc Plumbing OSprinklers Generator 0 Roof
Total Sq.Ft of Construction: Sq. Ft.of First rtoor:
Cost of Construction:S 269-00 utilities:0Sewer E]Septic Building Height:
illy
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: WNMotAp7plrlicable
Name: Name:
Address; Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
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 County makes no representation that is granting a permit will authorize theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or andcovenantsthat 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 recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF. IAIj<ijA,WQ 2\1yZ COUNTY OFINOInN RIVER
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of aIAZ.4, 20 €3 by this 4 day of JUNE 20 Ii by
mad JENNIFER M.RICHMOND
(Name of person acknowl } (Name of person acknowledgirr
(S' ature of Notary Public-State of Florida} ($jjdature of otary`Pubiic-State of Florida
Personally Known a OR Produced Identification .Personally Known x OR Produced Identification
Type of Identification Produced Type of identification Produced
Commission No E"2Z Q
te
mt)ot"PUbft$Uaf o ission No. FF2m24
. Jennifer M Richmond � � ' c Bort*mf Marl"
My Canmisaisln fP . • isfW3 CM Pid"l w
MY Carariirsbn FI:S�2S24
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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INITIALS