HomeMy WebLinkAboutBuilding Permit Application 08/29/2016 15:52 7724612036 STEVE SMITH AC PAGE 02/03
ALL APPLICASU I FO MUST 119 COMPLETED FOR APPUCATION TO BE ACCEPTED
Date, Permit Number:
Building Permit APPliCatiOn
Planning and Development Servicc5
Building and Code RegulaWn Division
2300 Wigmia Avenue�Fort Plerce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Selectliom dropbox, dick arrow at the end of lit*
Legal Description: J04ow
PropertyTaxlD#: Lot No.
Site Plan Name. Block No.
Project Name:
Setbacks Front Back- Fdght Side- Left Side:
I'm Gas Tank [:]Gas Piping U Shutters
OElectric UPlumbing 0$ptl6kiers Generator C1 Roof
Total Sq.Ft of Construction: Sq,Ft.of First floor: -&�a
Cost of Construction:$ Utilities:0 Sewer Septic , Building Height
Nam Name: Steve smith
Address: Company.
city: ZY, stai�:-4f-/ Address:8001 Eden Rd
Zip Code: City: State.Fl-
_fff'l Fax: Fort Pieme
Phone No. Zip Code: 34961 Fax: 772 461-20W
E-Mail: Phone No, 772 461-1425
Fill'in fee simple Me HoWer an next page if different E-Mail: steves Mthac@a0l-com
korn the Owner listed above) State or County License: CAC1813464 120071
08/19/2016 15:52 7724612036 STEVE SMITH AC PAGE 03/03
RE
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name. -- Name: _
Address, Address:
City: State: 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 apermit will authorize the permit holder to build the subject�rr cture
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,l 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 Cbmmencement 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 rk or rending your Notice of Commencement.
s
_Signature of caner/Lessee/Agent Signature of co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this„ day of it 20 .LS-by this AL day of P 20 -LS-by
(Name of person acknowledging) (Name of person acknowledging)
A V
(Signature of Notary Public-State of Florida) (Signature of Wotary Public-State of Florida)
Personally Known OR Produced identification Personally Known•^OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission No.ff vi-to "ier4ls140" ission No.fFw j-W-1 (Seal)
NOTARY NW101 s tNaleae swei m is
A&NSTATE OF 1L. ISA NOTARY PUBUC
M L411111111111-M
M $TATE of RDMOA
Revised 07/15/2014 > w 13N7/101$ C OMOPM1�
5/17'!201$
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
9PCOUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS