HomeMy WebLinkAboutBuilding Permit Application 12/02/2015 11:54 7727811307 FLYNNS AC PAGE 01
ALL APPLICABLE IN O MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "
Permit Number:
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IUME0.18
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1558 Fax: (772)462-1578 Commercial Residential _
PERMIT APPLICATION FOR: LOA
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Address: Uv
Legal Description: 5MIa iNn a- O ty . P ja�`T�ue'. / C�
Property Tax ID 1#: 10.3 ` 6 3 q S —(2 6 Q '—2- Lot No.
Site Plan Name: _-_ Block No,
Project Name:
Setbacks, Front Back: _ Right Side: Left Side:
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Additional work o ne orme un er t is permit—Check a appy:
HVAC M Gas Tank []Gas Piping OGenerator
Shutters ❑Windows/Doors
Electric Plumbing ❑Sprinklers El Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities, Sewer❑Septic Building Height:
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NameI T-
Address: i Company: "$ i-11
City. State: Address:
Zip Code: 77 Fax: City: Vt1` State:
Phone No. lD� �I — ��j�lf Zip Code: � �J_- - Fax: 77; 2S( —IWr
E-Mail:_V „ ,N�� �. __-- Phone No. -
Fill in fee simple Title Holder on next page(if different E-Mail: ' ` c) 17
from the Owner listed above) State or County License: A L $ -
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
12/02/2015 11:54 7727811307 FLYNNS 4C PAGE 02
DESIGN ER/ENGINEER: Not Applicable MORTGAGE COMPANY: 71Not Applicable
Name: Name:
Address: Address:
City: State; City: State:
Zip: Phone: Zip: Phone;
FEE SIMPLE TITLE HOLDER; \Aot Applicable BONDING COMPANY: ot 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 Colunty 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 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-r@sidential 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 your Notice of Commencement-
STATE OF FLORIDA STATE OF FLORIPA
The for - . t ent was acknowledged before me
,going ins rum The forgoing Instrument was acknowledged before me
# t'L-L vwA-X� .�-
ig'nature of Notary PLIblic-State of Florida (Sig;aiure of Notary Public-!rtate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
AR Im
Commission No. A "
Commission No. STA TF op L,
ivrw -CORIDA
COMRevised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE