HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-\ Permit Number: V<o(�'�-4313
RECEIV'7D SEP 19 2036
Building Permit Application
Planning and Development Services
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: P O
i
PROPOSED_IN ,ROUEIVIENT•LOCATION
Address: 3
Legal Description: 2S-' e K� F
LOT ` ^ 2
Property Tax ID#: ^' L �� ��J C)t'�D Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION.OI=IIV0RK:
LQ_Ja,i(\ 0±5
CONSTRUCTION INFORMATION.
Additional work to be performed under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ ����- cP Utilities: —Sewer —Septic Building Height:
QINNER/LESSEE CONTRACTOR
Name 4 1 Name: O
Address: Company:7 r -n-k
City: Stater _ Address:
Zip Code: Fax: City: r Stater .
� Fax-1-1 No. 2 .2` -3 833
E-Mail: Ir Phone No-1-1 2' �rI]kl -?s
Fill in fee simple Title Holder on next p i E-Mail 1t�CL_- - CLO
from the Owner listed above, State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SIPtEMENA4CtVSTit1 {`LOf tF1V1L4W f1�1OMAN
�tOs x y f
N5 F
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 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.
_Signature of Owner/Lessee/Agent S!oWure of Co actor/License Holder
STATE OF FLO UQA STATE OF FLO A
COUNTY OF �e �e COUNTY OF
The forgoing instrument was acknowledged before me The for ing instrument was acknowledged before me
this day of 201Coy this day of L_;A- ,20.L�_p by
(Narde of'person acknowledging) (Name of person acknowledging)
(Sig a gre�`otary`iPuublic-tate of Florida) (Signature f of Public-State ofFloj{de)�
Personally Known OR Produced Identification Personally Known tneed3
Type of Identificati P Type of Identificati P� GRIFFIN
MICHELLE W.GRIFFIN �''� s
_,,; t. Notary�Publlc,State of Florida
Commission No. , ': otary Pu§vdlate of Florida Commission No. a�� �a CommisslifiNalpF 968968
Commission No.FF 968968 %.,';�c►f�°,�°
, ,.. My Commission Expires 03!08 20
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�nmua�o
Revised 07/15/
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
COMPLETE
INITIALS