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HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC�.••LE INFO MUST BE COMPLETED FOR APPLICATION 7a BE ACCEPTED Date• . "t Permit Number: �1 OL{— aat\ • Olt .� RECEIV.'rD APR 0 g 2017 Buildillig.permit Application Planning an DevebpmentServfces Building and ode Regulation Division 2300 Virgin i, Avenue,Fort Pierce FL 34982 Phone: (77 462-1553 Fax: (772)462-1578 Commercial Residential PERMIT A PLICATION FOR; To Select from dropbox, click arrow at the end of line f '•x",$1`0•i%;• `•'!�-:, Address: Legal pescrip on: Property Tax #: 0 CxDct Site Plan Na Lot No:ls` Project Name Irl Block No. ti setbacks FiOnt^�� Back: Right Side: _ Left Side: �� ; rc V, - #io w to a er orme un er is permit--c ec a ,�sa ::�_ ~' OHVAC Gas Tank Gas Piping png _Shutters Windows/Doors Electric I Plumbing Sprinklers' Generator Roof Total Sq. Ft of �onstructlon: �Z2 S . Ft, of First Floor: Cost of Constr coon:$ © Utilities: Sewer Septic Building Height: Name y� ..;... ....;•;:;:,.: Name: Address: v�b�rn Company: s ` City: State : (-PU p / Address � Zip Code: Fax: - Phone N ( CEty:"P� State:Zip Code; Fax -"12-gC.e,t•iaii Phone No. Fill in fee situp Title Holder on next page(if different E-Mair.—IN p� c from the Owni listed above) State 9r e0unty License:in if value of const �ction is$2500 or more,a RECORDED Notice of commencement is r1aguired. 1 ,uti Y kjn: WAM RESIGNER/E OINEER: Not Applicable MORTGAGE Ct7M'PANY: Not Applicable Name: Name: Address: Address: city. i State; City: State: Zip: phone: Zip; Phone: JIF FEESIMPLE TLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City' City: Zip: Phone: Zip: Phone: I certify that n Work or Installation has commenced prior to the issuance of a permit. St.Lucie Count makes no representation that is granting a permit will authorize the permit holds to build the subject structure which is in con t with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Pleas consult with your Home fawners Association and review your deed for any restrictions which may apply. In consideratio f the granting of this requested permit,I do hereby agree that I will,In all respects,perform the work in accordance h the approved pians,the Florida Building Codes and St.Lucie County Amendments. The following b �Iding permit applications are exempt from undergoing a full concurrency review:room additions, accessory strut res,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING T !OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for imp ovemen ' to your property.A Notice of Commence ent must be recorded and posted on the jobsite bef a the fi inspection. If you 'ntend to obtain financi ,consult wit lender or an attorney before tom encin din r Notice of CQmmenc _ ent. i Slgnat, a of a see Slg a ure o Co tra ice se Hold STAT 4F F �tlpA COUEO OFORID COU O �� I .. The forgoing i ument was acknowledged before me The fo going instr ent,was acknowledged before me this�" day 20 by this T day of ._ 20 by .('..:.:,tar ` � S{ti�'� hC;•. (Name of p s ;acknowiedgin ) (Name of pe on acknowle ng) cs I nature of ry Public-State of Florida) 3 m gnature of oiary PubEic-State of Florida j a m 9 o' rbc c`, 2 y z Personally known ,-,"OR Produced Identific io Personally Knoll, no OR Produced Iden t s_ Pepe of Identification Known Produced � `P� Type.of identifi 'tion Produced 0 N "' C. C dY "( � (seal "� o commission No.� 3 ` (Seal) „;c Commission N `' "'-" 1' aaro -� r n' oa Y • Revised 071 . 12014 REVIEWS , FRONT ZONING SUPERVISOR PLANS VICtETATION SEATLlR"ILE MANGROVi COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS i �ii