HomeMy WebLinkAboutBuilding Permit Application-- ---- _ ... -- I E,j rwn rirrLtt:A i 1UJN I U BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade regulation Division
2300 Virginia Avenue, Fart Pierce FL 3498.E
Phone: (772) 462-1556 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address: 17_?
ICY PA Z /.vc 1 e L3
Legal Description: i Gcr(6- f'tr� ur-F f
Property Tax ID 4: �yr9 - 57a- mat
Siite Plan Name:
Project Name:
Setbacks Front Back:
YET -AILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lor No., -
Block No.
GSC r 111 & ",A(J.J'e-f 124c -PI rr2 _ q L� S'� �jl fGt -06V ,
CONSTRUCTION: INFORMATION:
A j�itiona workto be errorme Lin ert is permlt-e
[]HVAC Gas Tank 0Gas Piping
11 Electric XPlumbing ,Sprinklers
Total Sq. Ft of Construe tion:
Cost of Construction,
LJ shutters
Generator
S Ft. of First Floor: _
Utilities: Sewer El Septic
(� Windows/Doors
Roof
Building Height:
O NERILESSEE:
- CONTRACTOR:
Name ai7R. ArSOdt s Name: �� ti��LV
Addre5s.- rnae-ke-", dpvl Company: 2 .4 �tn26ti -
City: 6 L .Q State: i?L Address.: D, ' X Soja-dn ve.
Pip Code:
Phone _ Fax: City: 1�t. State: 5L -
Zip Code: -
�_..� Fax:
E -Mail: Phone No. 7 7 %-?P-7-
f Fill in fee simple Title (Holder on next: page (if different E -Mail:
rom the Owner listed above) State or County License:
i
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required_
SU
Name:
Addre{
City:
Zip: —
MENTAL CONSTRUCTION .LIEN -LAW INFORMATION. -
R: — Not Applicable
State:
FEE SifoPLE TITLE FOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY -
Name:
Address:
City:
Zip. — Phone:
BOUNDING COMPANY:
Name:
Address:
City:
Zip: —._a.� Phone:
Mot Applicable
State:
Not Applicable
I certify tat no work or i installation has commenced prior to the issuance of a permit.
I
St, Lucre County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is fn conflict with any applicable Home Owners Association rules, bylaws or anr3 covenants that may restrict or prohibit such
structure -I Please consult with your Home owners Association and review your deed for any restrictions which may appiy-
In consideration of the giranting 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
Comm, encing work or recording our Notice of Commencement.
Signature Of Owner/ Le
STATE OF FLORIDA,
COUNTY OF _ 5V L c ;`
The forgoing instrrtentwas acknowledged before me
this 7 day of f2i"P_r 20 [kby
(Name
Personally Known N1, OR Produced identification
IYPe ' _EatGiProduced
Commission No. _ y (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
COMPLETE
INITIALS
of Contractor
STATE OF FLORIDA
COUNTY OFF
The forgoing instrument was acknowledged before me
this day Of L£' trtc.(O 20 L— by
(fume
k
1
Personally Known ) OR Produced Identification
YPe .r, tton Produced
Commission NO. (Seal)
PLANS
REVIEW
VEGETATION
REVIEW
0
SEATURTLE
REVIEW
MANGROVE
REVIEW
I