HomeMy WebLinkAboutBuilding Permit ApplicationPTIGABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:-1\25\\T
" Building Permit APP|ication
Plonning and Development Services
Building and Code Regulation Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (7721 462-7578 Commercial Residentia l\1
Address:
Description:
Properry Tax lD #:Lot No.
Site Plan Name:Block No.
Project Name:
Setbacks Front- Back:
-
Right Side: Left Side:
permrt -applyr
I*,noo*s/DoorsEhro.
n r,"o,,.
Gas Tank num Piping Shutters
Generatorl-l etumuing nsprinklers tr
Total Sq. Ft of Construction:
-
Sq. Ft of First flqor:
-
CostofConstruction.5(0wUtilities:F,"*",E'"o,
tf value of construction is $ZSOO or more, a RECORDED Notice of Commencement is required.
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Company: t !Jl IffUrT fi\[,&{lJ :tl')r{-FlJ*'
E-Mail
State or County
Phone No. | | l,^ /-/Yl'
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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@-uotApplicable
Name:
Address:
City:State:
Zip:
-
Phone
MORTGAGE COMPANY:_ Not Applicable
Name:
Address:
City: State:
7'ip:
-Phone:-
FEE SIMPLE TITLE HOLDER:_ Not Applicable
Name:
Address:
City:
zip:Phone:
BONDTNG COMPANY:_Not Applicable
Name:
Address
City:
zip:Phone:
OW1Ugn/ 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 q;1!,4!9"18?.i#,lJYll:HJl:",JfS;!fi;:tg;t"!S[g!;,l?,?..':i}i:?f.i.ttiii,''.iti.li;it1t1r,
:{ii?tJiJ:r:S:l$"*,,.x fUfit$';lHS#:8fi,F# Association and review'yorii deed ror any ,"est,.ictio',isiJriiIt"ii''rv1tpiv.""'
ln 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
The foreoins instrumthtA dJv ot 'T ll"ffHeforeme
Name of person making statement
Personally Known b{-- OR Produced ldentification
Type of ldentification
Produced-
iCt0ui$ion#FF17?3n
iEr?ires: OCI28,2018
(signature of Notary Public- Stat
/ Lessee/Contractor as Agent for Owner
ng rns
Name of perspn making statement
Personally Known *F- On Produced ldentification
Type of ldentification
(Signature of Notary Public-
Z ilsFL72372
SEA TURTLE
REVIEW
ZONING
REVIEW
Rev.8/2/L7