HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIIC/A�BLE, INF I UST ECO PLETED FOR APPLICATION TO BE ACCEPTED
Date: I`�LrlPermit Number:
Building Permit Application
Planning and Developirt
nt Services
Building and Code Regtion Division /
2300 Virginia Avenue, Pierce FL 34982
Phone: (772) 462-155 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
,ddress: [ I V (
egal Description:
roperty Tax ID #:
ite Plan Name:
'roject Name: I
Setbacks Front I
Ci v
Zip Code:
Phone No. !��4
E -Mail:
Fill in fee simple Title 1 -
from
from the Owner listed
If value of construction is
Plumbing F]Sprinklers
in:
15r�' � �� S.
1 Utilities:
Lot No.
Block No.
u Shutters " Windows/Doors
F] Generator a Roof
Ft. of First Floor:
(Sewer OSeptic Building Height:
I
or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City:
Zip:
Phone:
State:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
Not Applicable
State:
Not Applicable
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes nolrepresentation 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 OWNED: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to yours 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 'record' ur Notice of Commencement.
I' i�
Signature of Owner/
STATE OF FLORI
COUNTY OF
The o Ing ins
this day of
1�I
(Name of person adt00,i
Lessee 1
N "$A
acknowledge' -4tfore me
20 Y
r
ng) ..
(Signature of i7ota7PIic- Stat&f Florida )
Personally Known R Produced Identification
Type of Identification Prod ced
Commission No. FE��� (Seal)
Signature of Contractor/License folder
STATE OF FLORIDA M
COUNTY OF
Theing ins u eJJ� s cknowledge fore me
this day of� l�C 20 y
(Name of pers L�Atnowedging)
(Signatur
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No !!�& 2 1 �(Seal)
•f `
CRYSTAL MARIE CRIIZADO
MY COMMISSION # FF993217
Revised 07/15/2014 �.
EXPIRES June 25, 2020
(407)399-0153
FlorndrNobrySerwA.00m
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
STAL Ut 1
MY COMMISSION # FF993217
EXPIRES June 25, 2020
14071-3"1 !, ►1�„{.:.nwr)q�fY104,CgRI
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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