HomeMy WebLinkAboutBuilding Permit Application DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not'Applicable
Name: Name:
Address: Address:
City: State: City: —state:-
Zip:
taterZip: Phone: Zip: Phone
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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'rrayxestrict,or,pr.ohibit such
structure. Please consult with your Home Owners Association and review your deed for any`restrictions which may apply.
in consideration of the granting of this'regpested 066 iit, l.do hereby'agre.e that•I will,inall respects;.perform the work
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,walls,signs,screen rooms and'aceessorV"uses'to`anothe`r 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 recordin our Notice of Commencement.
Signatur of Oder/Agent/Lessee nature of tractor/License Holder
STATE OF FLORIDA �. ATE OF FLORIDA ;�;?t *:�•;
COUNTY OF :;: UNTY OFt'
The forgoing instrument was acknowledged before me X-aT a for oing.instr nt was acknowledged before m o
this day of 202 by My s day of 20&by y��o
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(Name of erson acknowledging) 8,,4_4�1
( ame of p4rson acknowledging) T
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Signature o*y7OR
tate of orida) (Signature of otary Public-.State.of Florida)
Personally Known. Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ,'(Seal). Commission No. ` ' (Seal)
REVIEWS. FRONT ZONING•:,; : •SUPERVISOR PLANS VEGETATION SEA TURTLE;' MANGROVE
COUNTER REVIEWREVIEW REVIEW REVIEW: REVIEW - REVIEW
DATE
RECEIVED
DATE •_.
COMPLETED
ev.7/2014
All,APP'c4CARE.MFO MUST PE:COMPLETED FOR APPLICATION.T.O BE ACCEPTED
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Date:�at/ �Zl Zd �6 Permit Number: '
I
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential (�
PERMIT APPLICATION FOR:ON I,
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66.01 Fo2T NVALroN AyF-
ok
Address• '
j
Legal Description:
Property Tax ID#:1301 /6i200,%g0 06 Lot No.
Site Plan Name: Block No. /22.
Project Name
Setbacks Front Back: Right Side: Left Side:
t
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5 • f { S a A7• �. t 's �:I � Sf-' °¢'y''i t�5,.• 4'.Kt' -p• � K 7.,Z'..-
a :� +,� ^G i FA Amy ' .v •e. � "�Y Iii• * .'#t � \"
�4m '
dditio.nal wor to eperformed under this permit check allt 'at app y:
_Me'chanical _Gas Tank -Gas Pip'►ng _Shutters _Windows/Doors
_.Electric PlumbingSprinkler's '. i's, _
_ p Generator _ Roof
Total Sq. F,t of Construction: Sq`:Ff"of First Floor:
Cost of Construction:$ _;PaL7 Utilities: _Sewer _Septic Building Height:
Mal
Nameralf�014Ai2 lQED Name:1�GQOu BE�IAt_TTS/rt
Address:5Z01 PA490 _RfAole_ Cit Company: r��BE�tiy��T..IQ. CoFIST Co
City: Enrzr PES State: rf— Address:21'4! l�ptSL �,/E
Zip Code:.349`:f Fax: City: ry&-- Psc-F_1' State:
Al—
Phone No. 772— — 36!9 393/0Zip Code: 3!1-94h I'
Fax!
E-Mail: Phone No. 772-- _QAR0 Mn571-46615
Fill in fee simple Title Holder on next page ( if different E-Mail: Q,4 rir. F
from the Owner listed above) State or County License:e8GOZ2D94-
I
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ;