HomeMy WebLinkAboutBuilding Permit Application aALL• fa of sr : 'r -APPucATWN �a7�,�3
Date:
C C) .` Permit Number:
- R> CEIV ED FEB 10 2016
-&Sitio ftmAt"Apotication
Planning and Development Srrvices
quj1d6q and'Code Berguktb)7 DA4510n ; /
2300 irrgh o Avenue,s=ort Pierce FL 34-82 V
Residential 0)462-1553 ram( )Qsz- Commercial _-
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PropertVTaXID M rJ 5 D 2- �� `� Block No. —
Site Pial ftme:
. Paoject tstatrse: G
Sett>aeks fr6�vt ,_ >3ack: -Right Side:
t eft Stde:
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a wo mie un er a nrs --c a 'a app �''"�
HVAC Gas Tank as-Piping _ShrrtterS L.,. Mndows/Doors
Electric 0 Plumbing ❑Spriniders ElGenerator Roof
Total Sq.Ft of Construction: so.F#.of First({Floor:
Cost otConstruction:$ Po
Utilities sewer Useptic Building Height:
Mame:
Nattne � . .
Address: Company:
Com. Sta#e:� Address: �
Zip Code: Fax: City: Stater
Phone No. i l Zip Code: 3''-��� fax
E-Mail: Phone No.
Fill In fee si"W7-ffle-Holder on'next page-(if dlfferem E-Mail: C`�t 1r1
from ft&wner fisted above) State or'Coimty nse:
if vAue'af cnnstr ig'$MM or mom,�RECORWO Nonce of Comrt�Rgcement�retN .
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DE NGfNIz: Not Applicable7Addrets:
AGE COMPANY: Not Applicable
Name: .
Address:
City: State- City: State:
Zip: Phone- gip: Phone:
FEE SIMPLE TOREHOLDER: _Nat Applicable BONDING COMPANY: Not'Applicable
Name: Name:
Address: -- - Address:
City: City:
Zip: _. phone: Zip: Phone:
'i Certify that no work or'instailation has commenced prior to the Issuance of a permit.
St.Lucie.Cous�y make no representation that is granting a permit will authorize the permit holder'#o build-the subject strucwre
which Is imcon#liet•w€th arry applicable•Horne Owners Association rules,bylaws or and covenants that may mstrici or prohibit such
structure.Please consult with your Home Owners Association and review your-dead 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 b0iIding permit applications are exefnpt from undergoing a full concurrency revlew:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARM WTO OWNER:Your failure to Record a Notice of Commencement may result In your paying twice for
Improveinenfi�to Volar.property.A Notice of Commencement must be recorded and posted on the sobsite
before the first:inspection.If you intend to obtain financing,consult with fender or an attorney before
corrrmencig Work or recordin our Notice of Commencement.
. �-- S
/Agit QLicense molder
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STATE OF FLORID STATE OF FLOR
COUNTYOF COUNTY OF
The f g lnstrufa lovas acknowledge ore me The fo n instr a was acknowledged before me
this ay of 20 by this�y'a# 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known ✓ _OR Produced Identification
Type of Identificatli m
Pra ced Type of'identification Produced
Commission No. = •ORVST,�DUBVEDO Commission No.�,
COMM N FF804p4g RYSTA U�VEDO
IWIRES Jtd st MV'CC111IiMISS10N it FF904048
sea o+da rw ionro>erysorvr�ea+ EXINRiES,Iwy 34.2019
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW kEVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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