HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO iMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � II r I
Permit Number:.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: v
Building Permit Application
Commercial Residential
Address: / Vilma
Legal Description: cc> It�
- UKP
Property Tax ID #: _541q - gbi ° iic 1 E (Do og Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Block No.
✓Mechanical _ Gas Tank — Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing — Sprinklers _ Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $
Name i
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Address: q Kilp v %J��-t
City: Stater.
Zip Code: Fax: —
Phone No. 1 ? 60-351
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:p,,r
Company:�5> ;
Address:,'
City: Stater
Zip Code: Fax: -7 12 62 -q2
Phone No '7 Z� - , -7 %
E -Mail n '5 I (.f a Pit ,ccl
State or County License i t:s'7`?
h- >2 J..,U ii A4
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
.� W,. _
DESIGNER/ENGINEER: Not Applicable pp 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:
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 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 'in.%pection. If you intend to obtain financing, consult with lender or an attorney before
commencin w o ecording your Notice of Commencement.
Owner/ Lessee/Agent
"E OF FLORIDA ii
NTY OF L.
-CA
The forgoing instru'T_Tnt wips acknowledged before me
this day of 1'ri�. ' 20JJ by
ew-
(Name of person acknowledging)
(Signature of Notary Public- Ste of Flor- )
SABRINA L�OR
. A I< .G0MISS/py•.c !
Nary,FPersonally Known Produceaitiirlif,Oatior '?" `
Type of Identification
Produced =•a art 337
e < •• 4LrideM' 91 !;
•• �
Commission No. � ���� ". kc(1D \
1! 1 11111 Q0 r1 \`\\
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
of Contractor/License Holder
STATE OF FLORIDA j
COUNTY OF 0 }-� �_Lxe.A e,
The forgoing instru , ent.was acknowledged before me
this day of , 20 by
(NamTop
onacknowledging )
(Signature of Notary Public- State of Flor�,4 �,.:....•�
SABRINA L. "i �`\s40�E A
Personally Known V OR Produca 14MOtio s
Type of Identification
Produced ��7 7
Commission No_53off.
PLANS VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW