HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: °� 1 Permit Number:oco CJ��
- J
JUN 2 4 29,46
Building Permit Application
Public ks
St. Ducie CSL^=,��
Planning and Development Services u FL
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: Two Select from dropbox, click arrow at the end of line
1119,-No
Address: 7!-Q C) c 1 OY l '-
Legal Description.: SCcrnd7�1X
Property Tax ID#: 35121 UA — OOo S - 000 1 Lot No.
Site Plan Name: Block No.
Project Name: t OI wr Shor-eS
Setbacks Front Back: Right Side: Left Side:
N
wt :} +° �„� (:'�5 ail%► }"�'. g�� ';. y �i.�,`!"�t•, Sh -'. •� 4 ik b....',S .Q
A 4 �y, yYH ' t r t' "G, q f W s n r'W. Af-r s��,"FSfiv '�� '. f,
'��'?.:d� ''Fs' � _ za .,� "'s_ .3�! %�%� r k` d'^. iw L. [,3s ;.*�£ � 9.� +3a >tr.atJ_MEN
r1
a. P9—i Zoo sN
I..= PG I dAfpd NUII C1)Q�
I = PG i zoo SM (GLQSt-
t = CC, 36Do S14 K) TM PACT
SKWMM,51`14
41
NT3111i -0
Additional work to be pertormed under this permit-check all h appy:
HVAC Gas Tank E]Gas Piping _Shutters windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: a Roo . 9/ Utilities:n Sewer Septic Building Height:
MIER
Name a- rdii I Name:
Address: y20 S. J7 r. Company. �zUt--)
City:WW1 Q G State: FL Address:�1 �,lJuat� ' 2- Z-
Zip Code: v q of 5 7 Fax: City:s State:
Phone No. I S > �?)—(�� �� Zip Code:a?�,q Fax: '74S-QS32—
E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mai ► C�Cr�/� ? ir �,
from the Owner listed above) State or County License: �`f--)Cpsg21
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable. MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: Stater City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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 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 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.
s
_Signature of O see Agent Signature of Contractor/License Holder
STATE OF FLORI ( STATE OF FLO ID
COUNTY OF V COUNTY OF
r Ing in r ent was acknowledg before me The for ing instru a was acknowledge before me
t day o 20 tday of 20 by
1
F7(NAe of person acknowledging) (Name of'person acknowledging)
Signature of Notary Public-S ate of Florida ) (Signature of Notary Publi State of Florida )
Personally KnownOR Produced ovally Known OR Produced Identification
Type of Identification Produced MENS AR�Et 5Ty of Identification Produced
�cc� G :q„ i. P�(COM 16 Q
Commissio pF O � �ThNNOO1aryF W�ndo FJ ission No�ESSS' S Seal
;..
;a".'� MELISA ARMENTO
ION k EE 855825
EXPIRES:December 28,2016
Bonded Pau Notary Public Underwrders
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS