HomeMy WebLinkAboutBuilding Permit Application INFO MUST BE COMPLETED • ' APPLICATION TO BE ACCEPTED
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PlanningBuilding Permit Applicatio' n
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Building .
00 Virginia Avenue,Fort Pierce FL 34982
PERMITPhone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
APPLICATION • '
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Description:
Site .
Project
SetbacksSide:
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nal work to be performed under this perni-it---check—alFthat appryr
—Mechanical GasTank ' —Gas Piping Shutters Windows/Doors
)C Electric Plumbing Sprinklers • '••
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic I Buil,ding Height:
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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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 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 our Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OCOUNTY OF FLORIDA �, �Uti�� COUNTY OF STATE OF 5)
5) tucoe
The forgoing instrun ft was acknowledged before me The forgoing instrument was acknowledged before me
this ja day of J�V►le— 20 '1 1 by this_L!4_day of sl►jN,' ,20j by
(Name of person acknowledging) (Name of person acknowledging),
(Signature of Notiliry Public-State of Florida) (Signature of Notary ublic,State of Florida)
ersonally Known OR Produced Identification ersonally Know OR Produced Identification
Type o i ication Produc Type o I en i ication Prod
AN
°', ....'.. L WOOLLEY
( C RIs L WOOLL Flro y ) 'MY(¢QWISSION#FF096403
Commission No. � r9 I �o mission No.
OMMISSION#FF098 03 @XPIRES February 26,2018
EXPIRES February 26,2 18
ilILAM NraarySmj e.c9
REVIEWS FRONT ZONING SUPERVISOR NS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW ., REVIEW
DATE
RECEIVED
DATE
COMPLETED
-11—ev—.7/2014