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Building Permit Application
ALL APPLICABLE INFO MUSS' BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: hermit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-7553 Fax: (772) 462.1578 Commercial Residential Property Tax ID #: (,a C �" �— 060 •— tot No. Site Plan dame: Block No. Project Name: �1 oo Setbacks Front Back: Right Side: Left Side: DETA1LED J)8CRiPTi0N QE 14fl RK, A6 PL AC 15-0/W RA l L-ElO, SUVICC CONSTRUCTtai fN-,FOg 1iA-nON AciclitionaI work toe e orme un er t is permit— a ec a app 0 HVAC 13 Gas "lank []Gas Piping _ Shutters Q Windows/Doors Electric El Plumbing E]Sprinklers Generator hoof Total Sq. Ft of Construction: Sq. Ft. of First Floor:! v4 Cost of Construction: $ _ �20 00 Utilities: 11 Sewer F] Septic Building Height: OtIiERLESSEE £CNTRACTflR. Name 1"1©e City: oxf 5 I i]G�,_ State: (IPJ Zip Cade: �-2Pj� Fax: Phone No. E -Mail:. Fill In fee simple Title Holder on next page ) i DESIGNER/ENGINEER: Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Rhone: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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 fallowing 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 thefl� inspection. If you intend to obtain financing, consult with lender or an attorney before commenci ork or rmrding Your Notice of Commencement. Signature of Owry!iJ Agent/ Lessee STATE OF FLORID !�,,,,� COUNTY OF The forgoing instru ent as knowledged before me this,2k day of . r 20� by (Name of person a owledging ) of !Votary Personally Known v1-- Type of Identification Prodi Commission No. 4 10 Z CN --- '6o �. REVIEWS I FRONT l ZONING l COUNTER REVIEW DATE RECEIVED COMPLETED STATE OF FE COUNTY OF. The for ping insttu w ent s a nowledged before me this day of 20_L7 by (Name of person acknowle ing ) Y Cr�r�e. (Signature of Notary Public- Stat' of i=iiI111H1g11 VdRGj��,,�i��i Personally Known OR Prv,�n'--- Type of identification Produced : • ees 22, % er'; it r Commission No. +i 5,41 IIFsz h '� SUPERVISOR PLANS I'VEGETATION I SEA TCI<+AiT0ii%i %IPAANGRO REVIEW REVIEW REVIEW REVIEW REVIEW ,Arthur Snolmann lk Licensed& Insured 00003072 i AccuRATE ELECTRICAL CONTRACTINR Office: 772478.9171 Fax: 732-878,2854 Email-dovranchoatt.net 72.93 Sullattl Plane - Part SL Lucie, FL $4952 AM f s� p�jeL � " PVC 7AAjl-6'2 � Cil