HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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 your Notice of Commencement.
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Signature of Owner/Lessee/C t
ntractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 'kXt"
The fprgoing instr ent was acknowledgedJefore me
this day of ,)v2 Y 20 { by
(Name of person ackno ledging )
(Signature of Notary Public- State of Florida )
Personally Known_ OR Produced Identification
Type of Identification Produced
STATE OF COUNTY OFO 1#V0 (7aCAJ}
The f rgoing instru ent was acknowledged before me
this � day of :` Uya 20 L�E by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
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Commission No. rF222� A McQueen Commission No. I (Seal
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EXPIRES:
April Zu,�..rSaIAN #FF22?439
Revised 07/15/2014 ' '�>: • RONNOTARY.GOM = EXPIRES: April 20, 2019
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
Add rens: I M _a C
Legal Description:vlc�\, A,- c Lbtxp Cp r '112
Property Tax ID #: L�5j Lot No.�
Site Plan Name: _ Block No.
Project Name: M1'
Setbacks Front Back: Right Side: Left Side:
DETAIL D E C IP [ON'O d 3Rl a
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N TRUCTI IN O I Ai"I N
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Add1 onal work o be pertormed under this permit —c heck all apply:
HVAC E]Gas Tank ❑Gas PipinL Shutters Windows/Doors
Electric 0 Plumbing Sprinklers I _J Generator Roof Roof pitch
Total Sq. Ft of Construction: _ SFt] of First Floor:
Cost of Construction: $ I f, Utilities: I Sewer []Septic Building Height:
3i0WN g i E ' _ _
z' OTC#:
.,.
Name ik ter A�'ta'ja `l_ q Name
Address:jl�9" !'7 .l lxShr .1 1. �J�i Company: CcdI
City: Y'1 . State Add ress: I �,}t
Zip Code -.!5H Fax: City: State:
Phone No. Zip Code: Fax:
E -Mail: 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