HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED s1
Date.• Permit Number
RECE1'_'rJUL 3,1 1015 D ' "�'iw -- - —
Building Permit Application
Plgnning 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: Electrical
Address: 392L41
Legal Description: 1 Iri 114 C1
Property Tax ID#: Lot No.
Site Plan Name:-- Qlock No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�rn ra r
0 oaf a
Additional NrtoPe orme un er t is permit—c ec a appy:
HVAC Gas Tank Das Piping _Shutters E]Windows/Doors
Electric E Plumbing E]Sprinklers [Generator 11 Roof
Total Sq. Ft of Construction: raj S .Ft.of First Floor,
of Construction:$ _ Utilities: Sewer 1:1Septic Building Height:
Name Name:_
Addres Company:
City: State: Addres
Zip Code: Fax: City: State:
Phone No. "'7q Zip Code: fax:
E-mail: Phone No,
Fill in fee simple Title Holder on next page(if different E-Mail: r'.
from the Owner listed above) State or County License:
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
OLO/ZOoE kV3 0C:ZL 9L0Z/LE/L0
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: i Not Applicable
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 permit.
m
St.Lucie Coun 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 ang 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
I
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 wJFren`6e-roi;.kii attorney before
commencing work orteca ftnn*o-ur Notica4f Commencement.
signature of owner/Lessee Signature of Contra License Holder
STATE OF FLORIDA-- STATE OF FLORIDA
COUNTY OF COUNTY OF
The ping InstruInvas.acknowledgeA.6efore me The�ay
ng Instru t s acknowledged_hefore me
this7:Tday Of L 20 y this of ,ru C -120 )C�bV
6P t h- 31�
(Nameo e an ac nowledging) (Name of ers n ac ng)
kXA [J'a'M1(FJ6_J_` - - I
(Sloraoly_Pdblic-State of Noridg) ' (signature of Not Public-state of Florida) '
Personally Known�OR Prod jPersonally Known OR Produced identification
WalkN, pe of identification c
Type of Identification Produc a�.� SIERHANG RAI J-0 ifIcation Produc
bl" AMERALLU
Commission 4 FF 175017
fy
ion 0 FF 175017
Commission No, p4to Novembar9,2018 ammission No. Movembe�EArg,2018
ly
Revised 0711512014.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SfA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
owsoo In XVJ 06:zi. 9i.0Z/i_6/L0