HomeMy WebLinkAboutBuilding Permit Application ALLAPKicAsLe iNr-o-MusT BE COMPLETrm r-oft APPUCATION TO OF ACCEPTEI)
D. rT Olq-- 15 Permit Number:
............... ................................
Building Permit A0plication
Planning and Development-Services
Building and code Regulation DIVIsion
2300 Virginia Avenue,Fort Plerce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential V
g-gvgp
Address:
Un t+ 4d2
Legal Description:
PropertyTWO* 855S - LoO, -6)03o� DOP - -,5 Lot No._
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
R7
Q
g
Aidditi—ofia I w—o k -b-b e- r e Under pe heck all 1=apply.
ne rm(T —c HVAC r Gas Tank E Gas Piping L1 Shutters VAndows/Doors
[] bi11 •11klRoof
Electric Plumng 5priners G
Total Sq.Ft of Construction: So.R.of First Floor:
Cost of Construction: Utilities- Sewer Septic Building Height,
17 1 WE
_7
[Btu,
MEE .
*MS1MGNFE*_R/"ENGINEER: licable MORTGAGE COMPA Y: V_NbotApplf Applicable
Name: Name:
Address. Address:
City: State: City, State:
Zip* Phone; Zip: Phone:
;
_Not Applicable BONDING ?
FEE SIMPLE TITLE HOLDER: COMPANY: _Nott Applicable
Name: Name:
Address: Address:
City: city
Zip: Phone: Zip: Phone:
I certifythat no work or-installation has commenced prior to the issuance of a permit
St.L k
lAide Coun
Mirna, i
I=representation that is granting a permit will authoriziithe germit holderto build the subject structure
whic Jsin-cp Ictw! any;pplicable Home OwneOAssoclatldn rules,bylaws or an covenants that may.restrict or prohibit such
structure.Please consult wit, your Home Owners Association and review your deed for any restrictions which*mayapply.
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,.yo.ur 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 recordig&vour Notice of Commencement.
- ,, 0 %or/License Holder
e�siie
t
% e IA
�fCp
STATE OF FLOR STATE OF F
COUNTY OF COUNTY,OF'—'RW+-hu
th
T f
The I Zent a6knbwledge0efbre me The fo in Instruryant was ack4p
nowledgeefore me
r
this�Vday of 20by 20 ita
by
_Ct YYl 151 r\
(Name of person acknowledging (Name of person acknowledging)
i Ak
0 GW
(signature-oT NotarvyyPub c-Stfite of Florida) (Signature of Not'ry Public-State of Florida
Personally K"n Kit, Personally Know DR.. rwu�e�vl
d . CRYSTAL Ub.....
Type of Idema uced 1`ype of Identific i
's jda
11� Ju li :?*s
U f.7for
Notdry,public
at Comm,
Commission — -0- 115=5.... Commission*No.
..Iq-ftirm,ex 0 1311.2015 Uommiss!ofi
117478
_J
Revised 07/1512014 t 'ot FloridaFlo lda'
,Per,'It 13r
�E 11778
REVJEWS FRONT ZONING SUPERVISOR PLANS 'VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
MOTE
COMPLETE
INITIALS
EO/Z0 3DVd d3IW321d V60TZ69ZLL 9Z:PT 9T0Z/6Z/L0