HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning4
— 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:
Address:
Legal Description:
Commercial - Residential V",
Property Tax ID4. 5
5F �Z
Site Plan Name:
Project Name:
Setbacks Front— Back: Right Side: _ Left Side,
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Tour
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NsTAU ort.—M
ql_ J7!
alworktobte �orlmnec un e ��F,
t! r L p e rm rt — ch e ck a I
MAC Gas Tank E]Gas Piping
0 Electric ❑ Plumbing I Sprinklers
apply:
Shutters
Generator
Total Sq. Ft of Construction: SCL- Ft. of First Floor:
Cost of Construction: $ Utilities: LJ Sewer 11 Se—
ptic
Nam
L, LIC
T)p,
Address: lc4b(o rn
City: __Pc,( State:
Zip Code: Fax:
Phone No. -7-7 3)
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of Construct—ion is
Lot No. 1�
Block No. L47
Windows/Doors
Roof
Building Height: _
Name: az__11
Company:
Address:
City:
State:
Zip Code: HP7 S Fax: -77,2
Phone No. -7-7d g ':3-3"77
E -Mail: 5fL
State or Coun �yic
Ak ffSN Ac
or more, a RECORDED Notice of �Commencement is required.
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 ins cti4n. if you intend to obtain financing, consult with nder or an attorney before
commencing w a cording your Notice of Commencement.
_ ,sem Owner/ Lessee/Agent
of Contractor/License Holder
NTY OF r LA e� �*COUNTYCIF FLORID
1 . �_U_L .
The forgoing iinstrtATnent was acknowledged before me The forgoing instrur4ent was acknowledged before me
this day of 20 aby this _L5 day of 'b (f0J�r _ 20 1 7 by
�1 os* (
(Name of person acknowied ing) (Name of person acknowledging)
(Sign ft ry Pu c- of Florida) 11i11U1110l1f
[..�C���i
Personally Known OR Produced i,
Type of identification Produced
Commission Na.
#FF 195337 Q
Revised 07/15/2014
(Signatu f; eery bli t t Florida)
Personally Known OR Produced IdT
Type of Identification Produced
€ommissian No 337
0;-p, kNA L,
Sk
l) #FF 495337
REVIEWS
FRONT
DESIGNER/ENGINEER:
Name:
Not Applicable
pP
PLANS
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTER
Address:
REVIEW
City:
Zip: Phone:
State:
REVIEW
City:
Zip: Phone:
State:
FEE SIMPLE TITLE FOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
COMPLETE
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 ins cti4n. if you intend to obtain financing, consult with nder or an attorney before
commencing w a cording your Notice of Commencement.
_ ,sem Owner/ Lessee/Agent
of Contractor/License Holder
NTY OF r LA e� �*COUNTYCIF FLORID
1 . �_U_L .
The forgoing iinstrtATnent was acknowledged before me The forgoing instrur4ent was acknowledged before me
this day of 20 aby this _L5 day of 'b (f0J�r _ 20 1 7 by
�1 os* (
(Name of person acknowied ing) (Name of person acknowledging)
(Sign ft ry Pu c- of Florida) 11i11U1110l1f
[..�C���i
Personally Known OR Produced i,
Type of identification Produced
Commission Na.
#FF 195337 Q
Revised 07/15/2014
(Signatu f; eery bli t t Florida)
Personally Known OR Produced IdT
Type of Identification Produced
€ommissian No 337
0;-p, kNA L,
Sk
l) #FF 495337
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS