HomeMy WebLinkAboutBuilding Permit Application Date: �5 Permit Number,
RECEIVED NOV 12101
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 3498.2
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: N al'14
Legal Description; '^
Property Tax ID#:_LY957' 7—KAO(Y) QQC) q Lot No,
Site Plan Name:
Block No.
Project Name:
Setbacks Front LJ
Back: Right Side: Left Side:
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Additional work to be nertormed under this permit–check all h.ff appy:
HVAC 11Gas Tank E]Gas Piping -Shutters Windows/Doors
OElectric .0 Plumbing OSprinklers 0 Generator Roof
Total Sq.Ft of Construction: S Ft of First Floor:
Vg
Cost of Construction:$ L_ q Utilities:ll Sewer Septic Building Height:
Name,
- Ajamt: adw" aeAg<-
Adclress-_ _7� Compa4-2=NA'–��r-�np_s
City:-- )::� a4g'-w=g State:_a Address: 3*05Lf_'IV USS 14W
Zip code:3 L9.49
Fax:- - 6-1 22L City: Ervik p z b1C aStater
-xi '03 C) ZiCode: 84 (0 F (4(a
Phone No. jL p ax: 7 2m
E-Mail: Phone No-—----
Fill In fee simple Title Holder on next page(if different E-Mail: j5 Ja-�QtLrhVC1QC1(Q A.01._C_661
from the Owner listed above) 1J
State or County License: JoZ
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
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11-10-15;05:45 ;From: To:4621578 ;7724618722 # 6/ 10
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: _ Name:
Address: Address:
City: State., City; State:
Zip: Phone: Zip: Phone'.
FEE SIMPLE TITLE HOLDER: t Applicable BONDING COMPANY: of 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
whliu 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 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 with lender or an attorney before
commencing work or recording our Notice of Commencement,
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s
nature of Owner/Lessee/Agent nature of Contractor/License Holder
STATE OF FLORID ``7STATE OF FLORIDA
COUNTY OF . 1L1 COUNTY OF _/'4J�CC The forgoing instru nt was a4knowledged before me The for Ing instru ent was acknowledged before me
this day of d trM..b.D� 2l)/-5by this All of ���� 20 /,5 by
i0file'15 II'Des
(Name of person acknowledging) (Name of person acknowledging)
(Sigripfure of Notary Pubi n
Public-State of Florida) (Sature of Notary Public-State of Florida)
Personally Known � /OR Produced Identification Personally Known_{OR Produced identification
Type of Identification Produced Type of identification Produced
.�r mission Na. ,•;:R�^�;�' RA MOHMANN
Commission No. ANTRA HOHMANN .�•, Not���lic-S1ato of Flarlda
. I,;%•.- Notary Public-state of Florida =• My Comm.Expires Mar 14,2018
Mycomm. xp res ar - %;���� `��� 8ondetl Through National Notary Assn.
;,�\ r�'aCommission#FF 071680
Revised 47/15/2014 Bonded Through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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