HomeMy WebLinkAboutBuilding Permit Application FROM :cast electric FAX NO. :7725699775 Apr. 30 2017 6:37PM P10
ALL APPLICABLE INFO(MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //11
Date: _ Permit Number; 7 d5-0 0 11,-
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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)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:
Legal Description:
Prop"Tax ID#: 1Y/ Lot No.-g2&!!-
Site Plan Name: Block No.
Project Name:
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Total Sq.Pt of Construction: S .Ft.of First Floor:
Cost of Construction:S e� Utilities:12 Sewer Septic Building Height:
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Name t. ti).x i•.tlrh+ ` . F, �' .. ` 3. i ' : n. AIN,
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Address: : 1 —
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City: 1,Cr State:C� Address:
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Zip Code: Fax: City: Gv
Phone No. & p, (:�- State d
Zip code: Fax•
E-Mail: Phone No._�i 7 7.rI
Fill in fee simple Title Holder on next page(If different E-Mail: Ac -r�(� � �,,,� n
from the Owner listed above) State or County License-
If value of canstruction Is$2S00 or more,a RECORDED Natke of Commencement is required.
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SUPPLElVIENTAL CONSTRUCTlN,LIEN LAIN INFORMATIQN
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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 maty 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:iroom additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another n'on-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.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor License;Holder
STATE OF FLORIna STATE OF FLORIDA
COUNTY OF '-ZVt 1 l l! COUNTY OF
The forgoing instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this day of 20by this day of 20 by
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(Name rson acknowledging) (Name of person acknowledging)
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( nal e o otary Public-State of rida) ( ure of Notary Public-Sta Florida)
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Personally Known OR Produced Identification Personally Known OR Produced, Identification
Type of Identification Produced Type of identifications rrod
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REVIEWS FRONT ZONING SU PLANS VEGETATION ;SEA TURTLE MANGROVE
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DATE
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