HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAELS INFO MUST BE COMPIEMD FOR APPLICNfION TO BE AMPTED f ��T'�y�����
Permit Number: tI
Building Prmit Application
Planning and DL-vefoprnent S&ViCeS
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone.(772)462-1553 Fax:(772)'462-x,578 co mercial Residential
PERMIT APPLICATION FOR: To Select from ropbox,click arrow at the end of line
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Address.—AL_Le:p4
Legal Description.
Properly Tax ilk ff: Lot No.
Site Plan Name- Block No.
Project Name: gr,
ICILY f: Bnc) 7r-.
$etbacks Front_ Back._Right Side: Left Side:
A P
rp-s't d r-4(cd
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Addittqrftat work to narrormed under Ike permit--c�eca apply**:
UNVAC Gas Tank OGas Piping Shutters Windows/Doors
13 Electric 1J Plumbing IDSprinklers FIGenerator Roof
Total Sq.Ft of Construceton- SQ,Ft-of First Floor.
C05t0fConstruction:5 010� 0 0 Utilities:USewer Useptic Building Height
I'MEN ... .y. ... ..
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Name �V -P. ti r--,C) Name-
Address; land company: BmC6�thaxm El�[)Mdifiadylq
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City:W010 (')h Id-wit( -- - - State:Ld-T , Address: I r\qZ3 f3� bQ')M'A4
Zip Code, Fax-.--7-727-73q3-04-7�'� City- UA Cj P-
Phone No---1'7 9—,,)--cr-7 Zip Code- Fax,
1 E-Mail; qy-vS G+ ct
=Ca)C-DM���r�fCf- Phone No-
Fill in fee *6npie roJe Holder on r;e;i page(if different E-Mal"
from the owner listed above) state orl=nLic=nse. ��52M
it value of constmctlon is$2500 or moray a REGORGED Natioe of Commencement is reqtfyr*d.
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DESIGNER/lENGINEER: Not App{iceMORTGAGE COMPANY: —Not Applicable?
Name: Name-
Address. Address:
)city_ State: City: State.
Zip: - Phone: Zip: Phone:
EEE SIMILE TITLEHOLDER; Nttt Applicable BONI)INGs COMPANY: —Not Applicable
Name; Name:
Address: Address; .
City: City:
Zip: Phone: Zip-_ — Phone,
1 certify that no work or installation has commenced prior to the issuance of a permit,
St,Lucie Coun makes no representation that is granting a mel
ermit will authorize the et holder to build the subject structure
w1 ich is in conflict with any applicable Home Owners Association rules,bylaws or anst covenants that may restrict or prohibit such
structure.Please consult vift your Home Owners Association and review your deed for any restrictitms which may apply-
In consideration of the granting of this requested permit,)do hereby agree that i will,in all respects,perforin the wort:
In accordance with the approved plans,the Florida Building Codes and St,Lucie County Amendments-
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory Structures,swimming pools,fences,waits,signs,sc een rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Noti to of Commencement may result in your paying twike for
iovements to your property.A Notice of Corte ricernent must be recorded and posted can the jobsite
Xbre the first inspection.If u intend to obtain financing,consult with lender or are attorney before
cornmen-cing wiark ar reco gyour Notice of Commencement.
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$icrf ee/Agent 4 v/ ,7 stgeaatyir ract6r1tic se Holder
STAJORIDA STI.ORIDA
CO LvG� CO OF
Thefo[poing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Z )day of Ee42 . ,.� . 20 Eby this L fday of P �—"'z° by
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(dame of person acknowledging) (Name of person acknowledging)
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#signature of N 60y P 1&Iic-State of Florida) �— (Signature of kdEa u/Blit-State of Florida)
Personally Known ✓ OR Produces)Identification Personally Known v OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (seal) Commission Nn.�/ t Vit) {Sear
G l�l. Gerlde .�or-R. Cid H. f�t>#nde
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATICIN SEA TUKfLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
INITIALS