HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
solve
Building Permit Application
P!annino and Deveio.omenz 5envfces
Building and Code Reguiation,Division
2300 Virginia Avenue, Fort Pierce-L 34982 Residential J
Phone: (772)462-1553 Fax: (7 72) 462-1578 Commercial
PERMIT APPLICATION FOR:
Address: (� e
Legal Description:
Lot No.�_
Property Tax ID
Block No.
Site Plan Name:
Project Name:
Setbacks Front
Back: Right Side Left Side:
\l
"Oltionalwork to be pertormed under t is permit–cneCK all tat apply:
Gas Tank Gas Piping Shutters f Vdindows/Doors
_Mechanical _ —
Electric — Plumbing ,Sprinkler _Generator _ Root
Sq. Ft. of Fir sL rioOi:
Tctal Sq. Ft of Construction: I�
�s.1-�� Utilities- _Sewer _Septic Building Height:
Cost of Construction: 5
Name: ,, nouo nn(71
I Name `C� �?- (1— V 1���'�-- � � Company: @lair e.�:ise Cxp.ucs� uca i �� '
Address: '
S ate Address: 005 c^ aI ac i Di
City-
State:
1� State: Y i
Zip Code:
Fax: City:
; Phone No.
��2 �w,S17 '� Zip Code: 3693 ! rax: 3LI- 777- L123y
Phone No_ 7 7Z-337-z�147✓
E-Mail
i Fill in fee simple Title Holder on next page ( if different E Mzii: i wtesshaunna `D–t
State or County License:
from the Owner listed above)
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required-
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N Mall
01.0,MY W
rz
DESIGNER/ENGINEER: Not Applicable
MORTGAGE corviPANY: 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 2 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 covenant is that may restrict or prohibit��uch
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
commeqcing work or recordina your Notice of Commencement—,
s
Signature of Owner/Lessee/Agent Signature of Contractor/license Holder
STATE OF FLOaWA STATE OF FLORIFIA
iCOUNTY OF COUNTY OF
rd
The forgoing instrument was acknowledgeo before me
The for in i Lru en,was acknowledged before me
this da 2-0 1115-v 20 by
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Ing me f p ac n dgi I
gnat e t lorida U P N of Florida
Pe 11 own duced ldentificat;on P Identification
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EXP!Rff ibric25,2019 EXPIRES Une 5,2019
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Revised 0 7/15/2014
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW 1 REVIEW I REVIEW REVIEW
REVIEW REVIEW
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