HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-------- Permit Number:---------
Building Permit Application
Planning and Development Serwces
Building and Cade Regulation tnvtsion
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: {772) 462-1578 Commercial _ Residential _',I:,,,__ __
Property Tax ID#:
Site Plan Name: _ _\,,,M-1.JlA.:U"",J.!.L:.!'.l.,L""-'c::.l_�-------------
Lot No. 4
Block No. +--:J
k 3
W , /WW{
D Windows/Doors o.,
app y:
Shutters D Generator
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ert rs petmtt= c ec a
OGas Piping
Osprinklers
Back: Right Side: Left Side: _
Project Name:------------------------------------
Setbacks Front _
Total Sq. Ft of Constructio�
Cost of Construction: S _ _,�
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,
_
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s� of First Floor:
Utilities: LJ Sewer D Septic Building Height: _
Phone No .. _
E-Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) State or County License: �2_9_
5
8_9 _
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCHQN LIEN LAW INFORMATIO
_ Not Applicable _ Not Applicable MORTGAGE COMPANY:
Name: _
Address: --------------;=cc---- City: ------==-c-------State: Zip: Phone: ----
DESIGNER/ENGINEER:
Name; _
Address: ------------------ City: -----�-------State:
Zip: Phone:-----------
_Not Applicable FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:-----------------
City: -=----------- Zip: Phone: _
BONDING COMPANY:
Name:
Addres5'
-
-----------------
City: ----cc-------------- 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 rs granting a permit will authorize the permit holder to build the subject structure which ism conflict with any applicable Home Owners Assoctatton rules, bylaws or and covenants that may restrict or prohdnt such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideranon 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 len er or an attorney before
commencin work or record in our Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
The 0rnng instrument was acknowledged before me
this day of !Y\Q,,Y(,V) , 20 \g_ by
(Name of person acknowledging)
Personally Known OR Produ�tif1cat1on _:f::..__
Type of ldennhcation Produced \ _
Revised 07/1
Commission No. (Seal) ,.,.,._.Sl ... e'"""'"
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EXPIRE;;,. April S, 2019
6ondtd Thr u Nol� l'l*1!ic: Ur,derwriten
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS