HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: : -`-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
NLKMII APPLILAIIUN FUR
Address
Building Permit Application
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Commercial
y�Residential
Property Tax ID #:��zs -� /�%"'OTi30-�iiDO S Lot No.zr
Site Plan Name: igas,&A Block No. (Z
Project Name:
Setbacks Front Back: Right Side: Left Side:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _ Plumbing _Sprinklers _Generator <IcRocif t3 MI Fitch
Total Sq. Ft of Construction: MAD Sq. Ft. of First Floor:
,,-- 1
Cost of Construction: $ hili. �� Utilities: —Sewer _Septic Building Height: (tZ
City: W'V YM WLR State: TL
Zip Code,. + S'Ti Fax:
Phone No. 77Z-+34 L"3.S'M
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
z
Company:
City:
Zip Code: 3zftyL'
Phone No 77z— 3-ALS--
State
3s
State or
If value of construction is 2500 or more, a RECORDED Notice of Commencement is
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COCINTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
NLKMII APPLILAIIUN FUR
Address
Building Permit Application
�VGoht.�
Commercial
y�Residential
Property Tax ID #:��zs -� /�%"'OTi30-�iiDO S Lot No.zr
Site Plan Name: igas,&A Block No. (Z
Project Name:
Setbacks Front Back: Right Side: Left Side:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _ Plumbing _Sprinklers _Generator <IcRocif t3 MI Fitch
Total Sq. Ft of Construction: MAD Sq. Ft. of First Floor:
,,-- 1
Cost of Construction: $ hili. �� Utilities: —Sewer _Septic Building Height: (tZ
City: W'V YM WLR State: TL
Zip Code,. + S'Ti Fax:
Phone No. 77Z-+34 L"3.S'M
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
z
Company:
City:
Zip Code: 3zftyL'
Phone No 77z— 3-ALS--
State
3s
State or
If value of construction is 2500 or more, a RECORDED Notice of Commencement is
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
Address:—,'
City:
Zip: Phone:
MORTGAGE COMPANY: "Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: "'KNot Applicable
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a perniit 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 ppetmit holder to bpild the subject structure
which is in conflict with any appUgpWe Home QwcergApsociatida rules, tiylaws or and`covenants that may restrict or'proNbit 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; f dofiereby agree thatI will,4n'a4i respects, performthe work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendmerttq. -
The following building permit applications are exempt from undergoing a full concurre9cy review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms Ad accessory uses tolanother non-residential use
WARMING TO OWNER: Your failure to Record a Notice of Commencement may result Ln 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
STATE OF FLORIDA
Lf
COUNTY OF . o
The forgoing instr ment was acknowledge before me
this`V day of , 20L5by
`1
NJA
Name of paking state
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
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My COfnnl. txpkes Jul 6:20 t:
Signature of Contractor/License Holder
STATE OF FLORIDA!�,+�
COUNTY OF
The fo oing Inst ment was acknowledged before me
this day of o% , 201tby
Name of person king statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
Commission Ncq + A- Naury p'ubji
'I ZAA $if ,`/_il ,vommisslon #
,REVIEWS FRONT ZONING SIIpERVISOR PLANS VEG ,.., A GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW +REVIEW 1 REVIEW
DATE
RECEIVED
DATE
COMPLETED
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