HomeMy WebLinkAboutBuilding Permit Applicationi COMPLETED FOR APPLICATION TO BE ACCEPTED
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) 462-15-78
Commercial. Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 2-,"Y5
Legal Description: Ty- o o i
Property Tax I D #: 2, L4 I C) t) o 2-A - r) o JJ
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: . Left Side:
1, A
LA
TOIN
- " "r:- -1111 - "IeCK all appliy--�-""'
1LSHVAC Gas Tank Gas Piping _Shutters
1 Electric Plumbing O -Sprinklers ElGenerator
Total Sq. Ft of Construction: f
Cost Of Construction: $0 +215 0 0 irst Floor:
&--afET)iN — Utilities: Sewer 0 Septic
Na
mouress:7L__tl N
es
City: tiuz State:
Zip Code: 34 Q RZ Fax:�
Phone No. -1
E -Mail:
Fill in fee simple Title Holder on next �page_
from the Owner listed above) (if different
Lot No.__�
Block No.
Windows/Doors
lJ Roof = Roof Pitch
Building Height:
Name:
Company:
Address:
City: - State: �L
Zip Code: 3y 9 Lt
Fax:
Phone No. 11 z
E -Mail: 1�fna I
State or County License: i
If value of construction is $2500 or more, a RECORI7EO Notice of Commencement is required, �
DESIGNER/ENGINEER: ` Not Applicab
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address;
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
Not Applicable
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 our Notice of Commencement_
ature of Owner/Lessee/Contractor as Agent for owner
STATE OF FLORIDA
COUNTY OF _ 11v L
The forgoing instrument was acknowledged before me
this day of -4 20
J �s G
(Name of person acknowledging J
LCIL!l r—
(Signature of Notary Public- State of Florida j
Personally Known
Type of Identifical
Commission No.
Revised 07/15/2014
REVIEWS
COMPLETE
INITIALS
OR Produced Identification
- 4��= �_ s
Si ure of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF '- LUC F_
The forgoing instrument was acknowledged before me
this day of K , 20 (-1 by
(Name of person acknowledging)
(Signature of Notary Public- tate of Florida )
Personally Known _ 9 OR Produced identification
Type of Identificatio���+ - - - - - - - - -
IUMMUIINEEPPER r p:..... CHRISTINE CULPEPPER
VCOf�Ml3 3R GG061780 Commission No. = MYCOMMOMPGG061780
EXPIRES: January 11, 2029 EXPIRES: January 11, 2021
°..I g " Bonded Tluu Notary Pubk Undeiw 4n
FRONT I ZONING SUPERVISOR PLANS I VEGETA
COUNTER REVIEW REVIEW REVIEW REVIE
TION
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SEA TURTLE
REVIEW
MANGROVE
REVIEW