HomeMy WebLinkAboutBuilding Permit Application Page 1 oft 2016-03-15 17:01:04(GMT) 1772325U1o6 From: Kenee ueianunty
RECEI v'�C MAR 3 � 216 •
ALL APPLICABLE INFO MUST BE COMPt.ETED FOR APPLICATION TO BE ACCEPTED
Date:. 19. it,, Permit Dumber:1 0 1V(
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� �: ���t Building hermit AppliCatlon
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft.34982 `y
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
5ERMIT APPLICATION FOR. To Select from dropbox, click arrow at the end of fire
Address: R`
F f •,n dr• .fit v. L�ur thy. 4 "3� YY
Legal Description: 4 s•- d `
Property Tax ID#: �` F# .,.. ` / / . .. :y i .... r/ Lot No.
Site Plan Name: Block No.
Project Name:—
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Electric Plumbing OSp i r'nkl ers
Total Sq. Ft of Construction: A� kl SI
Cost of Construction:$ 1 � r Utilities:.` Height:
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E-Mail: %, .r+ '.Yr Y78 tis` r;?Yj-1 .i f:�..r Phone No.
Fill in fee simple Title loci` r on n page if different E-Mail:
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from the Owner listed above) State or County ucznse: A11.t '51 '6
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If.volue of construction is$25iso or more,a RECORDED N.ptice sf S ommencement is required.
To: Page 2 of 2 2016-03-15 17:01:04 (GMT) 177232501 08 From: Henee L)elanunty
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address,-.
City: State: City: State:
Zip.. Phone: Zip: Phone-
FEE SIMPLE TITLE HOLDER, �otAppFlcable BONDING COMPANY,. Not Applicable
Name: Name:
Address: Address:
City, City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure,Please consult with your Home Gwners Association and review your deed 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.Lurie County Amendments.
The following building permit 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 or recording your Notice of Commencement.
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-Signature of orner/fCssee/Agent j sign-afure oT Contractor/license Holder
STATE OF FLORIDA,,, STATE OF PLORIDVA
a- a iai
COUNTY OF Ne� - &ee COUNTY OF zur'i el-
The forgoing instrume kn
The for instrument was pcknowledged before me as a owledged before me
this Of '/0 by
this /Fulay of
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(Name of person acknowledging) (Name of person acknbW1edgI;g)"
C�6#0F-M
ful I I
nature 'Pubfi&stare of Florida)
(Signature of Notary Public-State of Florida) _(Sign
Persong I n Personally Known OR ProducedWentification
Type of tion Produced Type of Identification Produced A7
KATHLE1ENT-_bUMMtKb
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Co w4oqp --Wila CommissionNo. (Seal)
My Comm.Expires Dec 19,2017
mmlCommission#FF 069543 - n
LIbate ot>rl0tlds,.
Revi Omit, 11.8
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER I �V
DATE --[-REVIEW REVIEW REVIEW REVIEW REVIEW 7REVIEW
COMPLETE