HomeMy WebLinkAboutBuilding Permit Application ALL AP UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; Pe rrnit N umber:
17.
RECEIVED JUN 0 8 7016
Planning ani� Developpment Services Building Permit Application
Building andl,-ode Regulation o1vision
I i
2300 Virgini Avenue,Fort Pierce FL.349,92
Phone: (77 k 462-1553
Fax:(772)462-1578 Commercial
Residential
PLICATION FOR: To Select from dropbox, click arrow at the end of line
0
Address, 1911140017M
Leg I Descr
A 'AK�gq-KIN 111WINWAI,M,
Property Tax t it. -:3o-z Lot No,j
Site Plan Na
Block No.
Project Namet!
Setbacks •,nt ack
5 Right Side. Left Side-
15iN
t5 r.,
21w.
w k to be 6-erform-04 Ainde thisperrfilit–c. ec a 'AM apply:
V
Shutters AC Gas Tank Flas Piping U Windows/Doors
U Plumbing FiGenerator
Electric I Sprinklers • Roof
nstruction;
Total Sq.Ft ofi sSo,Ft.of First Floor:
ctlo Util s
Cost of Constr OSeptic Bullcling Height:
E,z
MINE
Addre
ir. City-, State:P,
i Zip Code: Fax:— 0-(.-[ •
PhoneNo.
E-Mai
State qr ounty License:
L
'10
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DESIGNERIE GityEER: `Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: ' Name:
Address: ,I Address:
City: State: city: State:
Zip: 11 Phone: Zip: Phone:
I '
FEE SIMPLE TLE HOLDER: _Nat Applicable BONDING COMPANY: ,_Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: phone:
I certify that nc#work or installation has commenced prior to the issuance of a permit.
St.Lucie Countl makes no represent tion that is grantinga permit will authorize the permit holder to build the subject structure
which is in con ct with any applicable Home Owers Association rules,bylaws or andcovenantsthat may restrict or prohibit such
structure.Pleasi consult with your Homeowners Association and review your deed for any restrictions which may apply. '
In consideriatlot of the granting of this requested permit,l do hereby agree that I will,in all respects,perform the work
in accordance v ith the approved plans,the Florida Building Godes and St.Lucie County Amendments.
The following b ilding permit applications are exempt from undergoing a full concurrency review:room additions,
accessory strut ires,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use.
WARNING T OWNER:Your failure to Record a Notice of Commencement may result in.your paying twice for
imp ovemen s to your property,A Notice of Commence ant must be recorded and posted on the jobsite
be f a the fi t inspection. if you'ntend to obtain financi ,consult wit lender or an a Corney before
cornencin ,int din r Notice of Commertc ent.
Slgnat i re of ssee Sig ure o Co tra ce se Hold
STAT OFF STA E Ot= ORIDA
r
COU O `_ 1 COU OF
The Poing In tr ^+was ,knowledged afore me The ftoin Yins#rurpent wasacknowledged re me
this _day 20_AAY this da of - .� 20
{Name of per o acknowledgin } {Nam per n acknowledgin
ignature
of tory Public State of Florida} ig. ture o ota P bI''- tate of Florida)
`,,pUa`r�,
Personally Kno' B. R ProQfitINdEdilif86tlon Personally KnownE22,2017 Type of tdentifi �� 'P Nufar Futrilc-State of Florida Type of ldentificatio- My C dnm.Expires J
M�tCom,,t.Expires Jul 22.2017Commis aQ FF2
Commission N apo imissl"eaff 038392 commission No. 2
Revised 07! 5/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALST_
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