HomeMy WebLinkAboutBuilding Permit Application Date: Permit Number:
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-Building Permit Application N
Plomkig and DmkpvneotSe"rzm o
aufAlwy apd Cade RegufaYion Diuisfoo
.2300 WrgOioAvenue,Fart Heece F134982
Phare:(772}462-1558 Pax I77z}462-1578 Commercial' Residential
PERMIT APPLICATION FOR: To Select from dropbox,.elic}e arrow at the end of line
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Address'. y
Legal DescrJptlon:
Propei-Ly-tax ii) Lot No. 2=-
.Site
Site Plan Ha me: Block NEI. _ z
Project Name:
5etbacks Front Back: Right Side: Leftside. a
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1-'AddttlonaiWDF)CtDbBDer'tOTrnedunder in Is permit—c eC C Bi I OU app :
NYAC
Gas Tank ElGasPiping nn_Shutters ElWindows/Doors
uElectric El Plumbing Sprinklers )_JGenexator 11 Roof
TP-ta I Sq.Ft of Construction: S .ft.of Fsrst Floor. x
Cosi of Construction:$ Utilities: Sewer)lseprtic Building Height:
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Name Name: GC
Add r ss c^' Compa3ty: o0
State Address f J� !2
CID
Zip Code "2F..- Crty: C1 State:Phone No. "6�� Zip Code:
E-Atail: Phone too. —S
Fill in fee simpleTrtle Holder on next page(if different
from the Owner listed above} State or County limnse.CDC
If value of construction Es$7-500 or more,a RECORDED Notice of Commencernerit is required.
70
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T2DMI!NEMR41 MEN 6 1 NON E E R: NotApplicable �Lj
MORTGAGE ODM PANY- —NotApplicable
Marne Name:
Address: Address:
City: State: City, State:
Tip:—Ph One: Zip:_Phone.
ry
FEE.SIMPLE TITLE HOLDER, —NotApplicable BONDING COMPANY: —NolAppricable
Name: Name:
Address: Address-
City: CIW-
Zip:—Phone: Zip:_Phone:
I c:er*that no work or lnstallat[on has commenced prior to the issuance of a permit.
St.Lucle County makes no representation that Is Nrantj7&errnIt*11-authorize thegermit holde subjectstructure
12 coven Q build tW
which Is in conflict with any-applicable Home owners As iatlonrules,bylaws or and ants atinayre ctorpmhlbitsuch
structure.Please consult VAth your Homeowners Association and review your deed for any-resvictions V;hich 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.ArAndmmts.
The following banding pertritt applications are exempt from undergoing a full cancurrehcy review:too m additions,
acFessorY structures,swimming pools,fences,walls,signs,screen roams and accessory uses to another nonresidential use r-n
WARNIN.G TO-OWNER:Your farlure to Record a Notice of Commencement may result In your paying twice for
imp rovernenls to your property.A Notice of Commencement must be recorded and posted on the jobsfte as
before the first inspection.If you Intend to obtain financing,consult w(th lender or an attorney Wure
Comm en cing work a r recordiniz vo u r Noli oe of Corn m encement.
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Signature of Owner/Agent/Lessee Signature of Gog6actorlUcense-Holder
STAT E OF F LO R IJDAcZ�% � 3 1 r—
_kU STAIT OF FLORIDA
COUNTY OF COUNTY OF '-�T
Therng Ins en was a ledgeljl_bel'bre me ThemgO re me
ihis;Wday of 20 Avby thisnLday 1 20-10 by
I Name of petion a edging J (Name of person aclawMed6rig)
J'ez
(Signature of Notary Pdllc-Stateof Fla—rr). (Signature of Notary Public-State ofrich
Personally Known,OR Produced Identification Personally Known X OR Produced Identifica1an CID
.Type of Identification Produced— Type crf Iderifficadov Prod a red
C2theriney4ftar C herine
Konw
Commission N Mmmission No. L
069RIMn rn
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Revised 07/15f2014 =aim 9M *-
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
rOUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INFrIALS