HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO'MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Date: 14�)
Permit Number;
Building Permit application
JAN 21 2016
PERMITTINGPlanning and Develap%nentSemi
ces
Building and Code RedUWlon Division I St. Lucie County, FL
2300 Virginia Avenue,fort Pierce FC 34982
Phone_(772)462-1553 Fax.(772)4624578 Commercial _ ROidential
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at thei end of line N
Address:
Legal D in: iv
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PropertyTax ID-9: W)L52- 15M
— Lot No.
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Site Plan Name: i Block No.
Project Name:
Setbacks Front Back: __Right Side: Left Side:
nut I
T-L CLO
2,/VD .TU) (0 4VVM
!R 11M i Ila
it a wor o e Oe ormed under this permit-cheCK all tn appy:
HVAC + -
EiGa.5Tank ❑Gas Piping Shutters a WlndowsJDadrs
Electric L_I Plumbing Sprinklers Generator g Roof
Total Sq.Ft of Construction�: --� 5 .Ft.of First Floor:,
Cost of construction:$ -� i _ Utilities:[—]Sewer E]Septic I Bullding Height:
Name Name,
Address: -� Company:
Cit State: t f Addre s:
Zip Code: Fa Ci State:
!'done No. Zip code- Fax:
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E-Mail: Phone Nn. '
Fill in fee simple TItip'Nolder on next page(if different E-Mail: -
from the Owner listed above) State ounty License;,
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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£0/Z0 39tid zIIti HCd3H N3SN3f 6£49696ZLL VE:60 9Z0Z/ZZ/Z0
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DESIGNERIENGINEEi Not Applicable MORTGAGE COMPANY: blot Applicable
Name: Name: i
Address: Address: '
City:. State: City. State:
Zip: — Phone: Zip: Phone'
FEE SIMPLE'YITLE HOLDER: ^Not Applicable BONDING COMPANY: Not Applicable
Name: ! Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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i certify that no work or Installation has commenced prior to the issuance of a permit.
St-Lucle County makes 0 representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with an yY applicable Home Owners Association rules,bylaws or and covenants that may resxrict or prohlbit such
structure.Please,consult w`th your Home Owners Association and review your deed for any restrictions which may apply.
in consideration of the granting of this mquested permit I do hereby agree that I will,in all res{78cts,perform the work
In accordance with the approved plans,khe Florida Building Codes and St.Lucie County Atnendibents.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swig riming pools,fences,wails,signs,screen rooms and accessory uses to another non+identlai use
WARNING TO OWNER;Your failure to Record ai Notice of Commencement may respit in your pjying twice for
improvements to yode property,i4 Notice of Commencement must be recorded,and posted on the jobsite
before the first inspealon.if you;intend to obtain financing,consult with lender;or an attorney before
commencing work orrecording VQur Notice of Commencement: `
Signature of Owner/Agen I..essee signature of Contractor/Llc nse older
STATE OF FLORIDA ; j STATE OF FLORIDA
-COUNTY OF tV COUNTY OF
The; no instr ent wa ac nowle0ge efore me The 'ng instr nt was c iedgUy
fore me
this ay o t3.. by this ayofm
(Name of person ackn Wledging) (Name o person cknowl dein
Lai
(Signature of Notary Pu ic-State of Kda) (Signature of Notary Public4fiate of Flori1a)
Personally Known ! OR Produce=d Identification Personally Known _OR Produced Identification
Type of Identification Produced Type of identification Prodgced
Commisslon No.� r Commission No.
ail`�V✓ 'Se
WWSfAL MARIE CRUZADO '• CRYSTAL MARIE CRADO
7463
i s e
Revised 07/151 sbe a� EXPIRESJune25, 16 1~XPIRES June 25.3 16
OW " sae o,ss
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUiVTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
E0/E0 3Jt7d KV HOd39 N3SN3P 6ELSESEZLL b£:60 9TOZ/TZ/T0