HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNER/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 the permit 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 your Notice of Commencement.
_'S gnature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF W r .1 n
The forgoing instrument was acknowledged before me
this _,LQ day of tr 20 j -by
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(Name of erson acknowledging)
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(Signature of Notary Public- State of Florida
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Sirature o Contractor/License Aolder
STATE OF FLORIDA ,
COUNTY OF
The forgoing instrument was acknowledged before me
this � day of _J a ;'7 c�, 20 1_2_ by
ffl l hQbnneW
(Name of person ackno ledging )
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(Signature of Notary Public- State of Florida
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Personally Known OR Produced Identification
type of Identification Produced_
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Commission No. ! :` a °, (SeaIPALE FULLER
,' MY COMMISSION#FF064. i8
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J371 398.0153 Floridallotaryservice.com
Personally Known OR Produced Identification
Type of Identification PnSduW'6 •,,
GA
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Commission No. MY ��tISSION #FF064558
EXPIRES October 20, 2017
-107 398-0151 FlnridaNntanV SPrvicP cam
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
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SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: To Select from dropbox, click arrow at the end of line
Address: (d5961 q P_d (-o— Avp- (-
Legal Description: Ole N 5q M( - p4 0 Sec, o} S Showy) i lit n i 2390 q34
oe(�q 1 f 15'19 �e (1r, -L QALLDu,- (BIk- 74 Lia
O -" ,SO `
4-
Property Tax ID #: 13 019 �] Z — 000 — 4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
HVAC 1:1 Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ d 6p6lo
�0a rIrnlb IuJ.711ULLCIJ
Sprinklers E]Generator
Sq. Ft. of First Floor:
Utilities: Sewer F]Septic
I i vvmuows/uoors
0 Roof
Building Height:
NamejnrMv.S yx Am rAt
Address: 6 6'M q "Co, �
City: P- pi PXCe- State: F71—
Zip
vZip Code: Fax:
Phone No. 5�f b (,� — -710q
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Company: ODonnell Impact Windows
Address: 6402 SE Federal Hwy
City: Stuart
Zip Code: 34997 Fax:
Phone No. 772-408-0200
E -Mail: rcodonnell3ll@gmail.com
State or County License: CRC1331273
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL