HomeMy WebLinkAboutBuilding Permit Application V
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date i Permit Number: l tl! 4
ILI
Building Permit ApplacaVon RECEIVEUz
Planning ofd Development services JUL 12 1016
Brdlding and Code Regulation Division
2300 Virgilio Avenue,Fort Pierce FL 34982
Phone:(772)462.1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address
Le jai Description: M2 /_f)+2 OLa107K�
Property Tax ID#: `Lg[) =(o, 0 ul D"f Lot No.�_
Site Plan N me: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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711-
al work o be nertormed under this perms —check all appy:
HVA Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
�Electric Plumbing Sprinklers GeneratorRoof
Total Sq. Ft of Construction: SQ.Ft.of First Floor:
Cost of Construction:$ UtilitiesSewer OSeptic Building Height:
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F E101
Name Name:
i
Address: Company:
City: State:_ Address: wa!s esP r ndiAinninN Im
Zip Code: Fax: City: Plaeg State:
Phone No.l Zip Code: Part St. Lucia,FLF3iW
E-mail: Phone No. -- -
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: a
required.
1
If value of onstruction is$2500 or more,a RECORDED Notice of Commencement is
DESIGNER/ENGINEER: Not Applicable r MORTGAGE COMPANY6. Not Applicable
Name: Name-,
Address:I Address.,
City: I State: City-, State:
Zip: Phone: Zip: Phone:
FEE SIMOILE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: I- Phone- Zip: Phone:
I certify th alt no work or Installation has commenced prior to the Issuance of a permit.
St.U makes no representation that Is granting a ermit illi authorize the permit holder to build the subject structure
gie CqunJ m u
whic Is in conflict with an PC
,�applicable Home Owners Association ru c bylaws or and covenants that may restrict or prohibit such
structure'Please consult w th your Home Owners Association and revliw'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 accordarice 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 s taccessory structures,swimming pools,fences,walls,signs,screen rooms and accessouses to another non-residential use
WARNINGI TO OWNER:Your failure to Record a Notice of Commencement may result In your pa_vins twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the Jobsite
before the first inspection.If wu4nterHOo obtain financing,consult with lender or an attorney be re
1.
commenciniz work or rjEf,4ft your Notice of Commencement.
e 'r4l
n r wner7%6nt/da&sCe n e of ContrQ
-O/Licenseolder
LTE OF:FLORIPA =ATE OF FLORI DB---
COUNTY I— iy-A- U_�_b COUNTY OF�__
The ng s acknowledge(
The f g instr me was acknowledgeltefore me Ava before me
this of tA 20—1 by this May of .20Ab by
In 4
-i ane
(Name bf person acknowledging) (Name of 0--r-son acknowledging)
J[gnat reofNotarV Public-State of Florida) (Signature f Notary Public-State of Florida
erson ly Known V"'OR Produced identification Personally Known_ZOR Produced Identification
identification Produced Type of Identification Produced
Commissio No. Commission NO.
NET TON
LYNNETTE AMI TON MYCONG51910NIUM808
MY CONINWMN 0 PF949M
W==W94 1 wu�
Revised 07/15/ l"
REVIEWSFRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I
COMPLETE
INITIALS