HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
C. P-4 T 'Y.,
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1.553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: � \iCK;(
Legal Description: W Y - f I it �- �11�- 32 �i'O�Y11aE C�V` P,�4k 1�n S 211.1W2 t. 6�` PD'�
Property Tax 1D #: , — C)�5G` Lot No. t4 A,
Site Plan Name: Block No.
Project Name:
r Sh`c
Setbacks Front Back: Right Side: Left Side:
Mechanical
Electric
-rormeo unc
Gas Tank
Plumbing
Total Sq- Ft of Construction:
permit --
Gas Piping
_ Sprinklers
Shutters
Generator
Sq. Ft. of First Floor:
Z Windows/Doors
Roof
Cost of Construction: $ _1, M .T, Utilities: —Sewer —Septic Building Height:
Name X t V
Address:
city: l' State: FL
Zip Code: F X - —NIA
Phone No.
E-Mail:I'l N
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: raanm wrt
J 1'rccr Sian
Company: M rise
Address: i (Ob 7omcx, a �f
City: Indian PArbMIZ lames ire State: l r
Zip Code: 32-g37 Fax: _32.1- 777- 0 q
Phone No. %7Z -337-L1 70
E -Mail. 6" C55 aun �l�os- �^'0 _.
State or County License:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Name: _
Address:
City:
Zip:
Phone:
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
State
FEE SIMPLE TITLE HOLDER: ^ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:`
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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
commencr x work or recordinkloir Notice of Commencement. „_
Signature of Owner/ Lessee/Agent
nature of Contractor
STATE OF FLO STATE OF FLORMA
COUNTY OF OL _ COUNTY OF c�ad
The for oing instru ent was acknowledged before me The
thisd� 20 Eby this
Identification
BondedThwN NRVFuo�;;UPAM Ors
Revised 07/15/2014
edged before me
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