HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 113��d Permit Number:.
_ Building. Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)46271553 Fax: (772)462-1578 Commercial Residential
PERM IT APPLICATION FOR:
Address:T8 7? C`ycYc� alp �h -1. AC/!'c ,,Ial 7e19 6P2
Legal Description: Zon Y ei Ae-J -vM', Dilee-)(r r17'10
J 7
?'1037 • aos saa • ,2 P 6 9• 3��s'-a �
Property Tax ID#: 330 - 40,T-- D O d 2- D d O -3 Lot No.
Site Plan Name: / Block No..
.Project Name: Gti .c�c�ch
Setbacks Front Back: Right Side:.. Left Side:
a � `r7 o
Gni V le- r i✓ Q h GC J(„84
;P44 edAt-w)h9 cf& L-y_ (A ,.,.4
itional work to be performed under this permit-c ec a tat appy:
_Mechanical _Gus Tank _Gas Piping Shutters _Windows/Doors
Electric. _Piumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ S. �/� Utilities: —Sewer _Septic* Building Height:
Name i c / u-1 i a Name:
Address: Company: GOa✓l-cl A,,W111V40
City: /Cl e G✓C a State: Address: 6.2,7 e s Awe re ,QLD
Zip Code: 3 q l yO 7 Fax: A-A City: f1 e✓Ca Stater
Phone No. �7. o&V - S91S-' `,0 60 Zip Code: 3��`��/6 Fax: 772= yi6l dg?JU-
E-Mail: Phone No. 7.2-
Fill in fee simple Title Holder on next page(if different E-Mail: 70- ,*We S v
from the Owner listed above) State or County License:
Et
of construction is 2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: =Not Applicable MORTGAGE COMPANY:. Not Applicable
Name: Name:
Address: it Address:
City: State: City: State:
Zip: Phone: Zip:.. Phone!
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPA : 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.
16 rtfythat'no.work or installation has commenced prior,to the i5suance.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 Owners 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.Lucie County Arrieridments. .
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 our Notice.of Commencement.
Signature of Owner Agent/.Lessee gnature.of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDI�
COUNTY OF ` COUNTY OF
The f r oing instrum nt was ocknowledg before me The forgoing instru nt was acknowledge. b ore me
this day of 20��jby .. this day of ..: O y . :.
Name of person acknowledging) ame of person acknowledging)
(Si f Notary Pu ic-State of Florida) _ (Signature of Notary blic-State of Florida)
PersorjalANW1i rradwed Iden fication Personal KCL'% 0AN8Ea4QwodFldentifi tion .
T e ' d t wid-.State of.Florida Type of I i3 P r6 A blic-state of Florida
f �A• +P Commission#FF 234730 +- ••; Commission#FF 234730
ComrrliSSi'fg F �� My Comm.Expires May 27, E Commissiof�; F oP°�' My Comm.Expires May 2�$ �
roug a conal Notary Assn: "' ��� one roug ational Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
-COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW,, REVIEW
DATE
RECEIVED
DATE .17
COMPLETED
Rev.7/2014