HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST Bra COMPLETED FOR APPLICATION TO BE ACCEPTED
Date -
Permit Number:
Planning and DevelopmentServlces Building Permit Application
Building and Code Regulation DIvlslon
2300 'Virginia Avenue, Fort Plerce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercfal
"_. Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSI~D INPROVEMENT LOCATION:
Address: Lq
Legal Description: _ (Ate) V , zo:
Property Tax ID #:
Slte Plan Name:
Project Name:
Setbacks Front, Sack:
—.Right Side: --Left Side;
DETAILED DESCRIPTION OF WORK: �Y______
CONSTRUCTION INFORMATION:
jj itEoni,
vv' or to e
Oe orme un er t
HVAC Gas Tank
11 Electric Plumbing
0
perm t—c Hece a
Gas Piping
Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $�
OWNER/LESSEE:.
Lot Na.
131ock No.
apply:
Shutters Windows/Doors
Generator Roof
5Ft. of First Floor:
utilities:cnSeWer Septic BuildingHei
ght: _.
Name
Address:
t
City:
State:.
Zip Code: L Fax:
Prone No,
E-mail:
Fill in fee simple Title Holder on next page { If different
from the Owner listed above)
CONTRACTOR:
Name: 06.A/
Company:
Address: SSC%�
city: 1'x'4
Zip Code; �3%� fJ' State: �[•
- Fax: CF6111
Phone No. 77�?
E -Mail:
State or County License: C C
-.=r
If value of construction is $2560 or more, a RECORDED Notice of Commencement is
required,
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 a first ins ection. If you intend to obtain financing, consu n attorney before
co encu rc or recon i ur Notice of Commencem
_ Signature of Owner/ Lessee/Agent �.
STATE OF FLORIDA
COUNTY
The r Ding instru nt wa acknowledge�fore
thi day of CTC 20 _ tby •�- i
il •�
r/�/1�} r� `� c
1 i I l� � /l ..��1HfUlr�.
(Namepf person acknowledging )
ature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of ��
Identification Produced
Commission No./EF-- `7` 6 ! /
-7 (Seal)
Revised 07/15/2014
STATE OF FLOR
COUNTY OF
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
thi�day of -AIL 20 by
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address:
City:
Address:
REVIEW
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 a first ins ection. If you intend to obtain financing, consu n attorney before
co encu rc or recon i ur Notice of Commencem
_ Signature of Owner/ Lessee/Agent �.
STATE OF FLORIDA
COUNTY
The r Ding instru nt wa acknowledge�fore
thi day of CTC 20 _ tby •�- i
il •�
r/�/1�} r� `� c
1 i I l� � /l ..��1HfUlr�.
(Namepf person acknowledging )
ature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of ��
Identification Produced
Commission No./EF-- `7` 6 ! /
-7 (Seal)
Revised 07/15/2014
STATE OF FLOR
COUNTY OF
FRONT
ZONING
�
The rVoing instru nt wasrrahhcknowledged b fore
m i
a
thi�day of -AIL 20 by
MANGROVE
1
o1D0
1 1
REVIEW
(Name of rson acknowledging)
sa
REVIEW
REVIEW
DATE
(ignature of tary Public- State of Florida)'''
Personally Known L` OR Produced Identification
Type of Identification Produced
Commission No. Q7 t % (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS