HomeMy WebLinkAboutpermit applicationALL APPLYICMLEIINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date — Permit Number:
(baa Mag Perm $ 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 nAo, L,.,
Address:
Legal Description:
Property Tax ID u: 196 U - I a by Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
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Total Sq. Ft of Construction:
Cost of Construction: $
Piping UShutters ❑ Windows/Doors
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Roof pitch
SFt. of First Floor:
Utilltles:]Sewer uSeptic Building Height:
City: TI' Ii e VCP State: F L
Zip Code: 9y Fax:
Phone No. --I -1 7 _2 $ S - ( y 2 5-
E -Mail: E -Mail:
Fill In fee simple Title Holder on nex4t page ( if different
from the Owner listed above)
Is $2500 or more, a
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state or county Ucense: -&Lptj
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'SOPPLEWIENTALCONSTRUCTION11EN LAW INFORMATION:`
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY: x_ Not Applicable
Name:
Address:
VEGETATION
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Address:
REVIEW
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
commencing work or recording your Notice of Commencement.
6
Contractor as A
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S"T _ u) 1 E I COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this V5 day of�AS� 20by this�dayof20�by
,1f W1F_S t Cog-1INlt=� I JFtNnFS F ('Z_1rALs
(Name of person acknowledging) (Name of person acknowledging )
of Notary
Personally Knowr�>� OR Produced Identification
Type of Identifications +
Commission No.
Revised 07/15/2014
of Notary Public -State
Personally Known OR Produced Identification
Type of Identifica on Produced
SUSAN MONTENEUNU
MYcOh(IBIAPN#GG 089099 Commission No.
EXPIRES: April 2.2021
Sonoco Thm Noun PUW UW&W*rs
SUSAN IAMMNEGRO
MY cohimissION # GG 089099
Bonded TMu Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS