HomeMy WebLinkAboutBuilding Permit Application A!!APP! B! # MBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Cate: � �� Permit Number:
REECEIVED
Building Permit Application DEC 2 8 2015
'Planning and DevelopmentServices PEWM ITTI NG
Building and Code Regulation Dlvijlon St. Lucie unty,FL
2300 Virgtnla Avenue,;Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial. Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lineA6
L
Address:
Legal Description:
Property Tax ID M. :f � 0� � (� � Lot No.
Site Pian Name: Black No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
C C FDr,5Ainr
I AA
nal work o ( orme under ss perm –c ec a app r
L
HVAC .J Gas Tank []Gas Piping Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Constructio J Sq.Ft.of First Floor.
Cost of Construction:$ Utilities;L.J Sewer D Septic Building Height:
NameMNameAA LC WA�
1 i n Name
Address: Ll (� Company:
city: State Addr ss: C,--
Zip
L
Zip Code: Fax. Ci Sta e
Phone No. �J if ' �O(� L Zip Code:— Fax: >
E-Mail: Phone No. !!!
Fill in free simple Title'Holder on next page(if different E-Mail: P101 �J
from the Owner listed above) State county Licenser
if value of construction 3s$2500 or more,a RECOODED Notice of Cnenroencement is required.
£0/Z0 39Vd NIV HOd3E N3GN3C 66LSCSCZLL ZO:LO IIOZ/51/60
D£SIGNER/£NGINEER; Not Applicable ` MORTGt GE COMPANY. Not Applicable
Name 'Name'
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name: _._.
Address: Address:
City: City:
Zip: Phone, Zip: Phone:
1 certify that no work or'instaliation has commenced prior to the issuance of a permit,
St.Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
Which is in confiiict"with any,applicable Home fawners 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,
Inconsideration of the granting of this requested permit,I do heroy agree that[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 p4rmit 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 o"r recording your Notice of Commencement.
Signature of(3wnerj Agee Lessee Signature of CpntraCtcar/t icertse folder
STATE OF FLORIDA n STATE Of FLORIDA
COUNTY OF �i l COUNTY OF
The ofd",w�as�acknowledge b re me The f in mens wasyacyknowledged before me
this/ � ''C1d�°f� a �, ZQ thi �o1Jf �Gdt. �spy
4-W 1
..........
(Name of pets n ackno +edging) (Name o on c owiedgi )
(Signature of Rotary Pub( to Fior da) (Signature of Notary u t e of rida
Personally Known QR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission Mo. �(seal) Commission No. (Seal)
(Seal)
,"• CRYSTAL MARE CRU
:•: tuY COMUMMN#EEi87
Revised 07/15/2014 1 MY COMMISSION 0 EE197463 EXPOM,Ains 25.2016
EXPIRES.lulu 25,2016
iss ,tom
REVIEWS . FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE,
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
i
i
60/60 39Vd gild HOV32 N3SN3f 6EL5CS6ZLL ZO:LO TIOZ/51/60