HomeMy WebLinkAboutpermit application.IpPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permrt Number.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial __
)ERMIT APPLICATION FOR:
%ddress:
Legal Description:
T -Irl /fie 1pr
M.a
/ J /��� _ L Lot No._— 1
Property Tax ID #: s�7 �%C�" ��� D Block No.
Site Plan Name:
Project Name: L ft Side
Mechanical
Electric
Back* Right Side: e
Gas Tank
Plumbing
Gas Piping
Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ / –
Shutters
Generator
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Name ,C,,Az e
Address: -
State:
City: oRTS
Zip Code:
Phone No. Ov-ss9
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Windows/Doors
Roof
Building Height: ___—
rti5 S Vit 0►1 S
Name: , I
Company: i',A<-re2et Ric��tSkoM- �G I
Address: «IS
SE C1ill
City: v
LkC r� State:
'Q -t �r JL -16-1 3 I X26
Zip Code: 42S' Fax:
Phone No. 11 3 13 2
IE -Mail: t I r CIC)
State or County License: CA C DSia �
if value of construction is 2.SKor more, a RECORDED Notice of COM
mencemerrt is required.
.VhD
Not Applicable
Name: I
Address: State:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name:
Address:
City:
MORTGAGE COMPANY:
Not Applicable
Name:
Address: State:
City•Phone:
Zip.
BONDING COMPANY: Not Applicable
Name:
Address:
Zip Phone:
Zip:
Phone:
CTOR AFFIDVIT• Application is hereby made to obtain a permit to do the work and installation as indicate .
OWNER/ CONTRA► prior to the issuance of a permit.
1 certify that no work or installation has commenced p restrict or prohibit such
makes n0 representation that i5 granting a permit will byl3ows Of 8nd cove holder
thatt maty the subject structure
St. Lurie County sent a Home Owners Association rules, r anyrestrictions which may apply -
which is in conflict with any app erform the work
structure. Please consult with your Home Owners Association and reviewthat Iw �° n all respects, P
In consideration of the granting of this requested permit, I do hereby agreeAmendments.
in accordance with the approved plans, the Florida Building Codes and Sa full is fur concurrency review: room additions,
tial use
The following building permit applications are exempt from undergoing uses to another
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory twice for
r must be recorded and posted n he jobeforsite
NTNG TO OWNER: Your failure to Record Commencementonce of C°r'^mencemerrt may result in our paying
WAR A Notice ofconsult with lender o
improvements to your property
before the first inspection. If you ou eNofice of Commencend to obtain ment.
commencingwork or recor ' /-) D,
Signature of Contractor license Holder
Signa�of Owner/ Agent/ Lessee
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
20 ! b by
this " , day of ��
t
SP M MG yl s'
(Name of person acknowledging )
(Signature of Notary Public- St of Florida )
Personally Known l/ ' OR Produced Identficabon
Type of Identification Produced OHRIgE B ENG
I MY COMMISSION # EE
Commission No. E S * EXPIRES: April4,
STATE OF FLORIDA L�z
COUNTY OF
rostrum nt was acknowledged before me
The forgoing' cj I ` 20L by
this_:., .- day of
REVIEWS
FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
COMPLETED
L �� � I <<5 -�l m I'n D ►2 � I
(Name of person acknowledging)
(Signature of Notary Pubbilic- tate of Florida )
Personally Known - OProduced Identification
Type of Identification Prod CHRISTINE B. ENGLIE
+ ) My COMMISSfON # EE 85f
ommission No.dill
EXPIRES: April 4,201
` Bended Thru Budget Notary Ser
SEA TURTLE MANGROVE
PLANS VEGETATION REVIEW REVIEW
REVIEW REVIEW