HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO BE COMPLETEDFOR APPLICA-MON TO BE ACCEPTED
Date Permit Number:
RECEI T Kc 15 2015
Building PernfitApplic'ation
Cc rx z '
Planning r ♦ Developipent Services
Building and Ir' Reeplation
2300 Virginia Avenue,-IFort Pierce FL 34982
Phone:(772)462-15.53 Fax:(772)462-lS78 Commordial- Residential
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Property . 01
Block .
Project
Side:Setbacks Front Back: Right Side: Left
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HVAC Gas Tank Das
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• 11pCinklers ,
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Fill In fee simple Title Ao er on ri�xt page(if different
from the •
J J T. • T r J J J •I
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DESIGNER/ENGiNER: _Not Applicable rAddre�s:gGE COMPANY: Not Applicable
Name:Address: i
City: f State: I City: State: —
Zip: Phone- Zip:.Phone:
FEE SIMPLE'TITLE H LDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: _ Name:
Address' _ Address:
City: I City:
Zip: Phone: _ I Zip: Phone:
I certify that no work or installation has commenced prior to the iuance of a permit.
St.Lucie County makes rjo representation that is granting a permit• ill!authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association r les,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home owners Association and;eview your deed for any restrictions which may apply-
In consideration of the gianting of this requested permit,I do her+'agree That I will,in all respects,perform the work �
i
In accordance with the abproved pians,the Florida Building Codes and!st.Lucie County Amendments.
The follo%iing building p¢rmlt applications are exempt from underg 3ing a full concurrency review:room additions,
accessorystructures,swimming pools,fences,walls,signs,screen r 3offis 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 yo i"property.A Notice of Coi'nmencerne�nt must be recorded and posted on the jobsite
before the first insp action. If you intend to obtain financing,consult with lender or an attorney before
commencin work or record' ur Notice of Commencement,
Slgnature of Owner/Agen/Lessee 4i9nature•of Contractor/License folder
STATE OF FLORIDA : ATE OF FLORIDA
COUNTY OF OUNTY OF
The ng ins n w0s ck o ledged�°re me - The or oing in ent w s tkr, ledged b ore me
this day of 20by his day of 20by
(Name of pe son ac n6Wledging (Naifie of erson ac Howl dging)
ALI-
(Signature o NotaryP�ublitt-- tat Mon a) (Signature of,4otary Publi -Stateg Florida) ,•
Personally Known " OR Produced Identification 0,ersonaliy Known OR Produced Identification
Type of Identification Prdduced Type of Identification Produced
Commission No. fission N
CRYSTAL•MARI GRUZADO _ CRYSTAL MARIE CRU
low 0_+
E197 03
Revised 07/15/2414 +• Ex>PIRW June 25.2016EXPiRES June 25,201
I!W34 .
REVIEWS FRONT ZONING SUPERVISOR -PLANS VEGETATION SEA TURTLE .MANGROVE
COUNTER REVIEW REVIEW REVIEW RMEW REVIEW REVIEW
DATE
COMPLETE
1 N ITIALS
EO/E0 39dd iJId HOd39 N3SN3P 6ELSESEZLL bE:90 ITOZ/ZO/60