HomeMy WebLinkAboutBuilding Permit Application 01/27/2017 11:38 7724626448 SLC CODE COMP PAGE 02/03
ALL APPFu—,
INFO MUST BE COMPLMD FAR APKICATION To BE Accurp
Date. 1 Permh Number:
RECEIVED JAI 2 7 37
Building Permit Application
Planriing and Developmenr Semites
Building and Cbde Regulativn Division
2300 btrginia Avenue,Fort Pierce FL,04982
Phone;(772)462-1553 Fax:(772)462-1.978 Commercial� Residential .->-,17-
PERMIT APPLICATION FOR'. To Select from dropbox, click here L%Yo,t kc h
OROPOSED INPROYt;MENT[_ t'ION: •. . ..
Address: 13
Legal Descriptior►:
Property Tax ID —C9 v� �r L9t No,
Site Pian Name:#: Block No.
Project Name:
Setbacks Front Back: Right SidetLQ+f Side:,_
DETAI 6 DESCRIPTION OF WORK:
!CONSTRUCTION INFORMATION:
Add
a oqa wor to rme un Qr t is permit—c e a appy:
[]
LJHVA( Cas Tank �as Piping _Shutters D,Windows/Doors
Electric Plumbing I. Sprinklers DGenerator !telRoof
Total Sq.Ft of Construction: S .Ft.of First loor:
Cast of Consction:$ Utilities:Sewer Septic Building Height
OWNS SE • CONTRA R:
Name Name
Add ELF
Company:
City; Statafa Address:
Zip code_ Fax, city: Stater
Phone No1 6 j Zp Cade: Fax:
E�Mail• Phone No. OW- ow . (I
Fill in fee simple77tle Holder en next page(if diftrent F"Mall,
from the owner listed above) State or County License:
if valum of aenstruction is$2san or more,at RECORDED Nodes of Commencement is required.
01/27/2017 11:38 7724626448 SLC CODE COMP PAGE 03/63
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNS VENGINE ER: —Not Applicable
MORTGAGE COMPANY. Not Applicable
Nome:
Name:
Address:
Address:
City: State: City:
Zip. Phione-. rip: Phone;
-
FEE SIMPLE TITLE HOLDER: —Not Appilicable BONDING COMPANY:
,Not Applicable
Name- Name:
Address: Address.
City: city.
Zip- Phone: 7Jp,_Phone:
OWNER/CONTRAC11101t AFFtDvrr.Application is hereby made to obtain a permit to do the work and Instaltation as Indicated.
I certify that no work or Installation has commenced prior to this issuance of a permit.
St.Lucie CoU makes no representation thatis granting a permit will authorize the pert it holder to build the subject structure
which is in conrn
conflict with any applICable Hoe owners Assoc Ation rules,bylaws at and covenants That may rarict or prohibit such
structure.Please consuitvAth your Home Owners Association and review your dftAd for any restrictions which may apply.
In con "c'I ratfon of the granting of this requested perml�I do hereby agree that I will,In all respects,Perform the work
an
In ace dance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
aeration
d
concurrangy review-m*tn additions,Thelb) ing building permit applications are exempt from undergoing a W[J!j
11
11
act structures,swimming pools,lentos,walls,signs,screen rooms access"uses to another non-residential use
WAR I G TO OWNE ,Your foilure to Record a Notice ment may result In your PaVing Wee for
G 0 *Mm I
C�you
IM ro entsto P ro erty.A Notice of corrirnerZeCment t be recorded and posted on the jobsite
on.
b or t e first inspe If yoU Intend to obtain financing C S I with le�er or an tr 6y bef6re
br11cQ nFyour Notice of Cornmenceme'n
COMM n i n a w-0-r-k cardia
Sig
natureTO"fterl A nV/Les—see Signature o root sse Holder
STATE OF XLO STATE OF R11
COUNTYO COUNTY fA-
' 0 - COUNTY
The Ing instru 5 acknowY�d d before 0
I 1:R er Ing in n Red beftim me
1)y 49
da by 20 by rn
rb da
th f7l 1 -20
theme of pTon ifAilawledging Ewa 4N ame t7f person wledging
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tSig eofNomryPu tic-StAteof Florida) IgnatureoMd 'ryP blic-511iteof Florida)
Personally Known OR Produced Identificatl 1110 rsQnaliy Known OR Produced Identification
:/P—M , i
Type of Identification Produced pe of Ideriffitil'] M roduced
CommIssion No. (Seal) y pmmission No, (seal)
Re4sed 07/15/2014
REVIEWS FiWNT ZONING SUPERVISOR PLANS VEGETATION SEATIJRTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW ASVILW REVfFW REVIEW
%A—T—F.
RECEIVED