HomeMy WebLinkAboutBuilding Permit Application ALLAPP'li �UE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date. Permit Number:
RECEIVED SEP 2 ZD16
1- L ID It I I
Building-Permit Application
Planning on:
I Develoi services -
Buli and�ode Regulation Division
2300 Vlrginlq��A venue,Fort Pierce FL 34982
Phone- (771ti 462-1553 Fax:(772)462-1578 Commercial Residential
,I)PLICATION FOR: To SelGet from dropbox, click arrow at the end oIi
f line (X
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2 EN :31
Address:
Legal Descr
PropertyTax It#: Lot No,
Site Plan Na Block No.
0o.
Project Nam
Setbacks lint Back: Right Side: Left Side'Ire :
NIV yi�lk4'
MIN
Pill
D
1W
M
--ftorm—pi under this permit–ch
•ddition to •epgr eck all--left .pi
H0 Shutters Gas Tank LIGas Piping s• !r•
Pb 'Sprinklers Roof
Electric •luming
Generator
Total Sq.Ft bf nstruction: Sq. Ft.of First Floor.
oouil• Height:
ion:$ Uti er 0 Septic
cost •f Cnstir, ilties 0 Sew • Bding
US—
-EVE
Zip Co e:
Phone o.
E-Mail,
Fill in fee Simi)".
im"M
1 1
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DESIGNER E Gi1tIEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: ! State., City: State:
Zip: Phone: Zip, Phone:
FEE SIMPLE VTLE HOLDER: Not Applicable BONDING COMPANY: .,_,,.,Not Applicable
Name.• I Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I
I certify that n work or installation has commenced prior to the issuance of a permit.
St.Lucie Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in con ct with any applicable Nome Owners Assoc[ation rules,bylaws or andpcovenants that may restrict or prohibit such
structure.Pleas consult with your Nome Owners As and review your deed for any restrictions which may apply.
In consideratio (of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance th the approved plans,the Florida Building Codes and St,Lucie County Amendments.
The following b Tiding permit applications are exempt from undergoing a fall concurrency review:room additions,
accessory struc res,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use.
WARNING T OWNER:your failure to Record a Notice of Commencement may result In your staying twice for
imp ovemen to your property.A Notice of Commence ent must be recorded and posted on the jobsite
bef a the fi t inspection. if you ntend to obtain financI consult wit lender or an attorney before
com encin din r Notice of Commene ent.
Signat a of ssee
Sig a ure o Ca tra ce se Hold
STAT' OF-F RIDA � STA E QF ORIDA
COu O COU T OF L ,r
The forgoing i trument was acknowledged efore me The for oft InstWent s ackn wie,,d,ged before me ;
this day LY`� � • zo Eby this My of {tU Y
am of a so ackno le ging) (Name of perso acknowledging)
Signature of tart'Public-State of Florida) (S ature of Nota Public-State of Florida}
Personally Kno n �-�OR Produc I ification Personally Known +—�OR Produced Identification
TYPE o Type of Identification Produced q
e{I yrs,,., ERAL �e�li'JUSSELL
a1 Flo Corrimission No. / fT"�� 1
com r 8 ; • �}.' ; Na ub is-5 ate of FIo0Qa
My y� a.Expires Jul 22, 0 '`� �� n9y Ccamn.Expires Ju!22,2017
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