HomeMy WebLinkAboutBuilding Permit Application (2) rI
AU,APPLICABLE INFO MUST BE COMPLMD FOR APPf-JCAT'0N'W 81E Ar-CEPTEP
Date: Permit Number:
Building P rmit Applicatidn
Planning and DevelopMent Services
SuddIng and Code Regulation Division
2300 Virginia Avenue,fart Pierce FL 34982
Phone-,(772)462-1553 Fax;(772)462-1575Cmercial Resi*ntial V/'
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PERMIT APPUCATION FOR: To Select from loPfox, dick arrow at the e4of line
Address: dfgw
Legal Description: nnn Chi b A& -T600
Property Tax 11)#- Lot No.—Z—
Site Plan Marne: Block No.
Project Name- , I h winaG W
Setbacks Front— Back: Rig t Side; Left Side,
V.
WIJ NO-1
L cui
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paa&0-8t, UPI
lokW
e ffo—rMe-d- un er M eCK 211 IMM apply-,
AC Gas Tank
OGas Piping U Shutters Windows/Doors
L31W
UElectfic Plumbing 13Sprinklers 12Generator Roof
Total Sq.Ft of COnstruction-, S Ftf First Floor;
—7—
Sewer Septic Bu ilding Height:
Cost of Construction:$ utilities-
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Name Name. x
Address;
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City: State., Address. '2.'�3, red
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Zip Code- - ff C1ty, f state-a
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PhoneNo_ Zip Code: '6q95--Q7Z 7-
E-Mail-- OssrYtoul aQe) Phone No-
IFill in feesimple Title Holder on next page if different E-Mail: C>-n�
fmm the owner listed above) state or County Ucense:
IfV31Ue Otconstrutdoin is$25W or more,a RECORDED Notice of Commenceineat is rlwqukred.
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Not Applicable
I}ESiGAIERf�1GiNEl;lit MGIRTGA6E COMPANY: �Not Applicable
Name: Name`
Address: Address:'
City- State: City: State--
zip.
tate:Zip. Phone- Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: tot Applicable
' Narne• Name:
Address: Address:
City City,
Zip: Phone.• gip: Phone.•
I certify that no work or installation has commenced prior to the Issuance of a permit
St.Lucie County snakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which 1S in conflict with any applicable Nome Owners As§ociation rules,bylaws or and covenants that rrnay restrict or prohibit such
strticture.Please consult with your Home Owners Association and rWew your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,l do hereby agree that i will,in all reSpects,perform the work
In accordance with the approved plans,the Florida Building Codes and 5t.Lude County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,signs,sc en rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Nati a of Commencement may result its your paying twwke for
improvements to your property.A Notice of Commncement must be recorded and posted on the jobsite
before the first inspection.It u Intend to obtain financing,consult with lender or as attorney before
cornrmenci k or recd our Notice of Commencement•
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STA IDA ST F CIRIDA
co OF •• Gr�GlGs' CO OF
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The forgoing iretrurnent was acknowledgedtb�efore me The forgoing Instrument was acknowledged before roe
this day of _ lx �'(,�t 2t3 1- by thts 16 day of .20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nt ry P Iic-State of Florida) (Signature of acy'pubiic-State of Florida j
Personally Known tf� OR Produced Identification* Personally Known v"I' OR Produced identification
Type of Identlfication Produced Type of Identification produced
Commission NO. AweOJ8 (seal} Commission No_ fD _3 D-5 (seal)
Cert H. Gentle � , Gard H. Genft
Revised 07-1151201:4 �'to���r Flcpir W.0% t9,2=M �- L JM11$�Z41t$
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REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MAPMGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLEFE
INITIALS