HomeMy WebLinkAboutBuilding Permit Application 1 ' 1 1 1 1 1• �� 1 1 1 1 1 1
ALL APPLICABLE • MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 15 G (3 4<1
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ECEIV7:D SEP 02 2015
10:
Building PermitApplication
Planning r r Development
Building• . Code Regulation
JI Virginia Avenue,Fort
Phone: 4. Commercial Residential
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Address: V
Legal Description:�
Property Tax I• •D yr o Lot No.
BlockSite Plan Name: /
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Adddjit�6nal work to be performed under this permit—check all that app
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TotalD Electric Plumbing Sprinklers Generator Roof
. of Construction: Ft. .f First Floor:
. ■—Sewer[]Septic Building Height;
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09/02/2015 10:05 FAX Del Air 0]0002/0005
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and 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 1 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 tA
improvements to your property.A Notice of Commencement must be recorded and poste e joKite
before the first inspection. If you int in financing,consult with lender or orne
-
commencing work or reco ' e our N of Commencement.
'::::�7_ / �J
s
ature of Owner/Lessee/Agent Sign rife of Contractor/License Holder
STATE OF FLORIDA wSTATE OF FLORIEKA
COUNTY OF COUNTY OF
The forgoing instr ent wa k owI dgedefore me The forgoing instrument was acknowledged before me
this�day of 20 fby this I day of �-f^ 20 1'S by
§�Y;--�w a•:.,�`�`' ROBERT G. DELLO RUSSO
_. ;
(Name of persona nowlIgii me of person acknowledge, :' MIl��OA
MY COMMISSION a FF 223790
REiRI�OAC.TIIRNEA 20'9
:r MY COMMISSION FF2�3790 / �: EXPIRES:June 14,
A's EXPIRES:,lune""20.9 ` BonedThnsWotaYPbfcr(Signature of Notary Publgnature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal).
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS.