HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE I !WISTR OLETED FOR APPLICATION TO BE ACCEPTED
Date: TMP
Ga t Permit Number:
Building Permit Application
Planning and Developr�jnt Services
Building and Code R tion Division
2300 Virginia Avenue, Pierce FL 34982
Phone: (772) 462- Fax: (772) 462-1578 Commercial Residential
PERMIT Appl_ICAJON FOR. To select from dropbox, click arrow at the end - of line
Address:
Legal De
scription:
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Property Tax ID 4: . 1
Site Plan Name:,
Project Name, Back. Right Side: Left Side:
Setbacks Front
T -r k - ft i <�i_Tz�LA
L_JHVAC '"I Gas Tank
0 Electric Plumbing
Total Sq. Ft of ConstrucIllon:
Cost of Construction,: $
Lot No.
Block No.
tnis perma - cnecK aii mat apply.
FGas Piping Winclows/Doors
Shutters 11
Sprinklers Generator Roof
S Ft. of First Floor:
Utilities: —Sewer
U n' " Septic Building Height:
Name Name- (2? r Y CY Q l(
Address: Q I z 01J. -b -AC Company: 15 "r— K,
StatJ',4 X
City Address:
Zip Code: 11 1Fax Citytl
Phone No. Zip Code: Fax:
E -Mail: Phone No.
Fill in fee simple Title H Ider on next page If different E -Mail:
from the Owner listed bove) State olaunty License:
if value of construction is $2soo or more, a RECORDED Notice of Commencement is required.
State: V L_
noon 00-001,
DESIGNER/ENGINEE Not Applicable i
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address: i
Address:
City: I State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: i
City:
Zip: Ph i;ne:
Zip: Phone:
I certify that no work or in has commenced prior to the issuance of a permit.
St. Lucie County makes noirepresentation that is granting a permit will authorize thepermit holder to build the subject structure
which is in contlict 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 grating 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 per it 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 nonresidential 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 jecordingygur Notice of Commencement.
Signature of Owner/ Agent/ Lessee
Signature of Contractor/License jlolder
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MY COMMISSION # FF993217
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