HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1�1) ,24 _q
Permit Number:
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 here
PROPOSED INPROVEMENT LOCATION;
Address:
Legal Description
Property Tax ID #;�
Site Plan Name:
Lot Na.
Project Name:
Block Naa_
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
AaditFona work to e e arme un ert is permit—c ec
Gas Tank DGas
a a AP y�
Piping
C�OHVAC
ectric
05prinklers
' Shutters
Windows/boars
Plumbing
Generator
� Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 1 -- lJtilities:
SFt. of First Floor:
Sewer
,.
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name f(Z
Address:
Name: -
ulfL'
City:
Com pa ny:
s".
St
Zi ate;
A C
Code: Fax:
Addy. s:
City: - .�N
f'i
Phone No,
'
i f
State:
Zip Code 1 C Dr
E -Mail:
Phone No. C —
Fax:
-
Fill in fee simple Title Holder on next page ( if different
from
E -Mail:
l v (I �
the Owner listed above)
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State or County License[;
If value of construction is $2504 or more, a RECORDED Notice of Commencement is required.
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RESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: _.. Phone:
FEE SIMPLE TITLE MOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:.
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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, l do hereby agree that I will, in all respects, perforin 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.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORID ,l STATE OF FLORI
COUNTY OF v COUNTY OF 1 {�
The fo oing ins rument was acknowledgedefore me The forgoing instrument was acknowledged before me
thisday of ZO L y ti this day of 20 b
(Name of persVn acknowl ging (Name of person acknowled i
re of Notary Public- State of Florida )
Of Not* P&Iic- State of Florida )
9too�
Personally Known �tiR Produced Identificati�t'rrry�,
- Personally Known �/A OR Produced Identification `� �'•*• 'r
Type of Identification ProducedType of Identification Produced
Commission No. qLl((SealjrIV'
'� Commission No:ifflif_l� (Seal)�jj�+'•`•�
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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INITIALS