HomeMy WebLinkAboutBuilding Permit ApplicationUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
23A0 Virginia Avenue, Fort Pierce FL 34982
Phone: (7721 462-1553 Fax: (772) 462-1578 Commercial Residential
Address:
Description:
Property Tax lD #:
Site Plan Name:
r+.D
Project Name:
Setbacks Front- Back:
-
Right Side:Left Side:
2'* r\
to'(N $ear
riut ftv liLe
AODIV:
EI HVAC
Electric
Gas Tank
Plumbing
[o,, Pipine Shutters
Generator
[-l *,noo*s/Doors
tr nsprinkters tr l--lnoot f Roorpitch
Total Sq. Ft of Construction:So. Ft. of First Floor:
utilities: [_lr"r", Et"*Cost of Construction' S i Building Height:
lf value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Zip Code: -lf1-'t L,iY Fax:Phone No.
E-Mail;
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State:1 \rdFT
OWNER/ CONTRACrOR 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 Countv makes no reoresentation that is srantine a oermit will authorize the oermit holder to build the subiect structure
which is in conflict with anv doolicable Home Owfiers AsSociation rules. bvlaws or and covenants that mav restrict or prohibit such
structure. Please consult with liour Home Owners Association and review'your deed for any restrictions vihich may apply.
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
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your payang twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. lf you intend to obtain financing, consult with lender or an attorney before
commencinS work or record r Notice of Commencement.
Signature of
STATE OF
ntractor as Agent for Owner
COUNTY OF
Personally Known ,^*
Type of ldentification
(Signature of Notary Public-I(onger
#FFL72372
Name of person making statement
Personally Known A OR Produced ldentification
Type of ldentification
(Signature of Notary Public-
i=-=C@igion# FFynn
r's Expires: OfI 28, 2018
BONDED THRU
1ST FLORIDA NOTARY II.C
MANGROVE
REVIEW
SUPERVISOR
REVIEW
DATE
COMPLETED
Rev.8/2117