HomeMy WebLinkAboutBuilding Permit Application r
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: I
Building Permit Application MAY 1 201
Planning and Development Services _ ' TTING
Building and Code Regulation Division M.
FL
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: 7 Vmi CACT
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Legal Description:
PropertyTax ID#: . i:__—> OMS Lot No.
Site Plan Name: Block No. I
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Add
itiona I wo rk toe e orme un er is perm —c ec a appy:
OHVAC Li Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
U Electric 0 Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 9�' Utilities: Sewer Septic Building Height:
Name OHA/ Ofd CFF(^ Name:
Address: 70"( 44M IOt C I' Company:
City: PS L State: P L Address:
Zip Code: 3 q l$Z Fax: City: State:_
Phone No. 77Z 7r) 9 oZ Zip Code: Fax:
E-Mail: IS t EwAN7) C/ ro,..1 Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SSULMEI�ITAL�C( 1SlfCTOIIA INORIa/I�tI�i � � �
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,I do hereby agree that 1 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 our Notice of Commencement.
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5i ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder I
•' 1111
S ATE OF FLORI A STATE OF FLORIDA
COUNTY OF--5]t_/4f C.a COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day of 1��r 20 JLby this_day of 20 _by
!✓rte" r--lic:
(Name of person acknowledging) (Name of person acknowledging)
I
(Signature o otary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Pro uced Identification Personally Known OR Produced Identification
Type of Identification Produced jf H(1e `c en 1. Type of Identification Produced
Commission No.PIC 1b Od 0 (Seall Commission No. (Seal)
BRENDAN SGARL TT
MISSION#FF960076
Revised 07/15/2014 ?w;u EXPIRES February 11.2020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS