HomeMy WebLinkAboutbuilding permit ALL ALPLICLE INFO MUST C COMPLETED FOR APPLICATION TO BE ACCEPTED
bate Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: `j `-t_ q Lt Lot No.
Site Plan Name: Block NO.l l
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED"DESCRIPTION OF WORK:
064 a/leey /co er) ref)-)6(ht-iq e<i S4-f(Y? 62 lurn /- ' -
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CONSTUCTIQN INFORMATION:
itiona war to (ee ( 1`11,111C11 un er t is permit—c �Ppty.
BH Gas Tank Gas Pi inge r s Q Windows/Doors
Electric ❑ Plumbing r..� g �Sp inklers nGenerator � Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
t5 �j
Cost of Construction: $ 1 E .-2-Z UtilitiesSewer QSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name.
Addre �� Company: f.
Y Se. _ -�
Cat tat Addr s:i � f[-
Zip Code: L4 Fax: City: �; c i Stater
. - S T
Phone No. � LdLLC Zip Code..- > Fax: ; le
E-Mail: Phone No. r' ` Od
Fill in fee simple Title Holder an next page ( if different E-Mail n Y)cM(th T
from the Owner listed above) State or County License: —,Y-,
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable 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:
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 1 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 inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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4rignaituji-rLe-of Owner/Lessee/Agent Atn ure of 6Contractor/License Holder
STATE OF FLORID STATE OF FLORIPA
COUNTY OF Z4 _on COUNTY OF
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Type of Identification Produced _ = Type of Identification Produced .�'
Commission No.� qL1 1 (seal} 1 .y�•+y_,.� Commission No.FFQL1 (5eaf)
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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