HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
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Planning r d Development Services !s•
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Building r r Code Regulation
/1 Virginia Avenue,Fort
Phone:(772)462-1553 Fax:(772)462-1578 Commercial
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Address: :ii' FortWalton
Legal Description: Lakewood • 63 Lot .• I (OR 929-1950)
••, * 1301-606-0110-000-1Lot No.
Site • an Name: Block No.
Project Name. Garman
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Total Sq-Ft of Construction: Sq.Ft.of First Floor:
Cost of • f 7000.00Utilities: ■SewerF SepticBuilding
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if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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09/04/2015 15:19 1 ELITE ELECTRIC INC PAGE 05
20 25
11
DESIGNER/ENGINEER: x_Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 thepermit 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 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 t ecord a Notice of Commencement may result!n your payinge-P6
improvements to your property. otice of Commencement must be.re and poste the jobsite
before the fir ection. If u intend to obtain financing,consult lend or an orney before
commen ' work r recor n our Notice of Commencement.
S
S' nature wn Lessee/Agent Signat e o a /Lic se Holder
STATE Of FLO IDA STATE OF FLOR
COUNTY OF saintLUCIe COUNTY OF Saint Lode
The fo gging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of_JM 20 Lby this 4th day of September 20 /s by
John A.Pankraz John A.Pankraz
(Name of person acknowledging) (Name of person acknowledging) /
piaci.-
(Signature of No ry Public-State of FI ida) (Signature of Notark Public-State of Florida
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
EE830242 ; �� fro mission No. :�°' W� LEE
Commission No. ,,nYo «- e Y LEE LANGFO EE830242 'p Y LAIVGFOR
�. COMMISSION#Eli y. � MY COMMISSION#EE8302
a EXP! ''•'� arc
{407)396-01a3 FtoridoNotaryServtce.00m 1407)39&0153 F1060NoteryServke.Z.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS