HomeMy WebLinkAboutBuilding Permit Application Jun 23 2015 09:12:40 Via Fax -> Vonage Page 002 Of 003
.ALLAPPL€GABLE INFO-MUST BE COMPLETED FORAP.PiiIcitTION'TO' t.:ACCEPTED": ::':" " :..:...:,..;; •.. .•,:.
Date: i<' Perrriiu urn'er: ...'1
:
,
RECEIVED""
Planning and Development Services . . •':.: . ".�U.N 2.� 2015•• •. ..:.
• .Erullding and Code Regulations Division . .•
2300 Virginia Avenue,Fort Pierce Fc 34962
:(772)462-1578 Cor6ercilPhone:(772)462y1553 Faxesidential
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PERMIT APPLICATIONAPPLICATIONFOR:
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Address: ? >,� ' " ` '" -r { f
Legal Description: 1, � y ... " f"1' o•.€"�
Property Tax 1p M.
-� a Er. �t �•€.� '� Lot No.
Site Plan Name: � Block leo. F'
Project Name:
Setbacks Front Back: Right Side= ,Leif Sade;
MEN=
111-41 1&'5e.'�':!v 1 pe d_J.
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itippal wor to e QertoR ied uriclertrus perm[ ,..c ec a appy:
HVAC Gas Tank 0Gas Piping _shutters E]Wiridows/Doors
Elwric U Plumbing. Sprinklers 0 Generator Roof
Total Sri. Ft of Construction._ S .Ft,of First Fluor:
Cast of Construction:$ utilities: Sewer se' tlC. ., Building Height:' ' '
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Phonc`i4ln. "... 3 T 7I 'Cpi - Fax: W
E-Mail. Phone lVo: ;` "'irk s 77
Fill in fee simple Title Holder on newt page(if different E-Mail- .�z�
from the Owner listed above) State or County
if value of constrjiC Gn is$ 5oti or more,a RECoR CorCnmeP1&eme' k It retpuired,
Jun 23 2015 09:14:02 Via Fax -> Vnnage Page 003 Of 003
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DESIGNERIENGINEER; _Not Apptieable MORTGAGE COMPANY-, ��Not.Applicable
Name: Name:
Address:
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City:
y State: City
Zip- Phone. 2shone _._
P .
State•
FEE 511!liPLE TITLE HOLDER,
,,,,,Not Applicable BONDING COMPANY: ,ZNczt Applicable
Name- Name:
Address: Address:
City:-- � .. ..•... �.-,..��.,. .. . twity:
Zip: Phone: .w._.„_,.. --- Zip:
I certify-that no-wotk or iriAaliation has cont m:'e.n�Vd peloc
St.Lucie County makes no representation that is,granting a permit will a uthorizi~,i:he, erm1t holder t0'bUiid t he sijI.jec,structure .
which is in conflict with any applicable Harne Owners Association rules,bylaws or anci covenants that may restrict 0rprohibit such
structure.Please consult with your Home Owners Association and review yo.ur.deed for any restrictions whi, may apply.
In consideration of the granting of this requested permit,I do hereby'agree that 1 will,'in ell respects,perform the work
in accordance with the approved plans,the Florida$uiiding Costes and St. Lucip County amendment,.,
The following building permit applications are exempt from undergoing a full concurrr'noy review:room additiOttS,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Not-ice ofCommen cerntnt may result'in your paying twice for
improvements to your property.A(Notice of Commencement must,be recorded and posted on the jobsit4"
before the first inspection" If you intend to obtain financing,,.consult with tender or an attorney before
CQmMencing•work or recordin our Notice of Commencement,
tore of Owner/Lessee flgan$ "SiRnarure of Contractor/License P colder
may,
STATE OF FLORIDA �COUNTYOF . STATE.OP FLORIDA
'Thefdr`going'iiy;�trurncnC was acknow)edaed before nye•. COUNTY 0F__!24jj=G-'-C1'
The'forgoing•:Aroment-was-acktiowledged bOore me ,
thisr�Clay of _' ,;, M rr` 20 by thi ,2M,di3Y�f '_���'._" �..: :.,Y_�� by• . ,
(dame of person acknowledging (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary E�ublie-State of Florida)
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:Personaf y Known•• __,,-QR'Pfbduced tden.' {3{1�; l `.P&sahbllY;kn
'Type of Identification Produce_-_ 'a�� hype of tienCifiriAn 4?rtduietl v ,se", �`, . ..
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Comraission No. ( lk"« � "� l�frrmissitln fro.µ a° Via.) ...., ::.
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Revised 07/1.5/201 �'.,' - c ..•'Qw ';'<:; °i:' F��� _�,
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REVIEWS rRONT ZONING � SUPERVISOR PLANS SEA TURTLE MANGROVE
COUNTER REVIEW t REVIEW REVIEW''' REVIEW' REVIEW REVIEW`
DATE
CC3NtPLC•TE
INITIALS