HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE
fI/NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_, 7 '� Permit Number: Lz(�1' 01; 0
'1�15 RECEIVED
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Building Permit Application AUG / 4 2017
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
—710
op 0401P
Address: f62
Legal Description:
Property Tax ID#: L �b � � j _(� Lot No.�_Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
`DESCROMON t WQRK:
'Z
AdditionAl
, work to be rme under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters l]Windows/Doors
F]Electric 0 Plumbing F]Sprinklers [i Generator F�Roof Roof pitch
Total Sq. Ft of Construction: �7 SQ.Ft.of First Floor:
Cost of Construction:$ I Utilities:R Sewer O Septic Building height:
� ERA
E: CONTRACTOR.
1
Name (i Name: AA`.
Address: Company: �, `4- It ► i r
City: 0c-A k State: Address: AN-
Zip Code: Fax: City:PD r r Si]0 i? State:
Phone No.6(9 1— yl-0 q��� Zip Code: 49 9 �;> Fax;
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: rr t?1 ✓ C'e r
from the Owner listed above) State or County License: o�
if value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
. �tQMMUCTION UEN LAW INFORMATION:
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 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
commencin work or recording our Notice of Commencement.
nature o ner/lessee/Contractor as Agent for ure of ont or/License Holder r
STATE OF FLORIDA STATE OF FLORIDA <Z��4 ( 2N
u
COUNTY OF � � L - COUNTY OF
The fo oing instru ent was acknowledged befor «� ' The for ing instru ent was acknowledged before co.- ro
n,
this day o (y— 20 aby LU law this day of 20 L by �Lu
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4 X v I Y i1J
Dg v le o S-e r) �' m ��GCV ct 13 C- I z
(Name of person acknowledging) (Name of person acknowledging)
e°
t
(Signature of N Public-State of Florida) (Signature of Notary lic-State of Florida)
Personally Known OR Produced Identificatio Personally Known OR uced Identification
Type of Identification Produced Type of Identification Produce= 't-- 7 i
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALST__