HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE IN M T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
.ate Permit Number:
J_
Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1.578 Commercial
Residential L- -
PERMIT APPLICATION FOR: To Select from dropbox, click here -
PROPOSED INpROVEMENT LOCATION:
Address: r ✓1 ��r
Legal Description:
Property Tax ID #:I c `5,,
Site Plan Name:
Project Name:
Setbacks Front_ 3aci€:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�I —/) i ,, . _ nn _
0
Qr
CONSTRUCTION INFORMATION:
�tiona wor to e e orrne un er t is perm t c ec a appy;
< _`T`
C�HVAC Gas Tank G
Lot No.&�_U�
Block No.
r
L.1 Windows/Doors
Roof
Building Height:
Fax: _
a
Ufre'*c'tric
as Piping
El
El Plumbing []Sprinklers
Shutters
Generato r
Total Sq. Ft of Construction:
Cost of Construction: . (� Utiiities:'Sewer
S
Ft. of First Floor:
�—
E]Septic
OWNER/LESSEE.
Name (1
CONTRACTOR:
Address: In
Name: I](-
City.
Stat
Company:
Addr
Zip Code: Fax:
Phone No, ��� cT
City:
E -Mail:
Zip Code
Phone No.
Pili in fee simple Title Holder on next page ( if different
from
E -Mail:
the Owner listed above]
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Lot No.&�_U�
Block No.
r
L.1 Windows/Doors
Roof
Building Height:
Fax: _
a
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address: -
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
—Not Applicable
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 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 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.
ignature of Owner/ Lessee/Agent s
�Si n ure of Contractor/License Holder
STATE OF FLORID V 1 STATE OF FLORI
COUNTY OF COUNTY OF _
Theor ping instr ent was acknowledges' `zefore me
this day of 0t 20 ; by
J }
(Name of
4%
The for Ding instrument was acknowledged before me
thi:Eday of �i 20 j_ by
CM n
re of Notary Public- State of
Personally Known L__�OR Produced Identificati
Type of Identification Produced
�l I �=
Commission No. (Seal) 'pr• s;
if
Revised 07/15/2014
REVIEWS �FRONT ZONING
COUNTER I REVIEW
DATE
COMPLETE
INITIALS
`yyulN7!(l+jai
Personally Known (/� OR Produced identification' A *•
Type of Identification Produced tea.
Commission No.E �1}��S � _� (Seal) '�,' •' �':
. _ nirun*
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
AAoar,11, N4F- Farmtt,V
``i a� �AkC ,�Tofj Coup -T
ELECTI UCIAL RISER PLAN
/F ;\ NOT TO SCALE �f�^ i T- �
0, Underground
O Overhead
12S
I- SizeService:
2- Conductor Size:
3.a. Meier MaiEn:
b. Meter Can. Only: Yt"S
AMP
Dc �- — CroundIng E lectrode Conductor Size
❑ #6
Zk #4
CJ #2
Q - Other
CONSTRUCTION TYPE -
0
Coimrnercial
a
Residez'cial
0
Mobile Home
Nrw Installation
0
Old Installation
ESTI 1 ? k(2 Mtn[ N
I'L�;ANIP TO r-cpI e 'FLv(;{{
Vr NtG SAT- VA, T
s u RfACE r -f-D LLj,-�MEruTS.