HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICAB E INFq 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) 462-2578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT:
:
-SUPPLEMENTAL-CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/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, l 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 vour Notice of Commencement. _
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF "CLY+i rl
for oing instr ment was acknowledged before me
Vi I�"day of i 1 20 Eby
NaIZi endeaul
tof person acknowledging)
ature of Notary Public- State of Florida )
Signai'Erre of Contractor/License Holder
al
ZONING
SUPERVISOR
STATE OF FLORIDA
COUNTY OF li.Vm 1/1
VEGETATION
The forgoing instrument was acknowledged before me
MANGROVE
this IZTday of avrl I .20 I- by
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
orally Known OR Produced Identification ')<- Personally Known OR Produced Identification k
of Identification Produ UL. Malo • I ll.o--+l • UL41 ' 0 Type of Identification ProducedrtDL'• L� Ill® � I • Ul.f� 'D
r�p.S�T- S 1 -=-APS I2-IT/25
nission NJy& 3 2-U3(Seal) Commission No. GG 32-Zo(Seal)
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS