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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:- MMMM Permit Number: w Building Permit Application planningand Development Services Building and Code Regulatlon Division 2300 Virginia Avenue, Fort pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 452-1.578 C'ommercia( R�sldential PERM IT APPLICATION FO R: To Select from dropbox, click here _ - PR�It7sI �.IPIovrr�T LocaTQ.N, Address:;, c- X `iC(s ( Legal B:escrlption: _-7i 1 S C ? { 4 e Property Tax i!D #: - tl ?, �) O&o Site Plan Name: Lot No.� Project Name: Block No, Setbacks Front_______ Back: Dight Side: Left Side: D 7AI :>=D QESCR PT i`3IV. C}F 0R—K 1 � -�-c^� � i Imo_:. � • � ' CIL C43 N STR U CT C? Rl I„N; 4 R MATE O:N.. ions uk+or oe orme un gr1t sperm' c pr L.JHVAC L,—J Gas Tank,-,-•, — Gas Plping 1 Shutters Windows/Doors electric 9- Plumbing Sprinklers Generator � Roof Total 5q. Ft of Construction: S Ft, of First Floor: Cost of construction: $ � �t � � � C' utilities' Sewer Z septic Bulldin g Height: Name 4p Address: 7 < NameUN e 61 tt R A+ IU.DA City:1 Co6mpany: � � 'lir • `, C I�? 21p Code: Fax: State: Address: 5c� /, r r5 carp r lrIeb Phone trio. - �� _ , Citv: f ��r�' , i L:"•e,r�r * ZIP Code: 2 State: ��• E-Ma11; � Fax: 7?a ..6Y7/_ 01g&& Fill in fee simple Title Hblder on next page ( If different Rhone No. is-Mali.X71 from the Owner listed above] ' 1'�v4 C,i . vv� state or County License: C If value ofeolistructlan is $2544 or more, a Ri±CORDED Mlotiee of mmCceuRired—� G4 4+-(.5 � �i�� ���ea§'�.. .�.r�;; i .5 -S..if .ar .�. n.._.�":o- �•. ��r.S��� ,fir �'�.'r��:."... 'ter. -5. s—.£". - DESlGNER%ENGINEER, _ Not Applicable MORTGAGE COMPANY, � Not Applicable Name• Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _ Not Applicable Name: Name: Address: --- - Address: .,... City: City: Zip: Phone: Zi Phone,. 1 certify that no work or installation has commenced prior to the issuance of a permit. 5t. Lucie Counfv makes no representation that Is granting a permit will authorize the ermlt holder to build the subject structure which Is In con ict with any applicable Home Owners Association rules, bylaws or an 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, wails, signs, screen rooms and accessory uses to another non-resldentiai 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 tie firstink ect�alf ynu intend to obtain financing, consu eatiorney before o Slgnature-of owner/ Lessee/Agant as STATE OF FLORI ACOUNTYOF The forgoing Instrument was acknowledged before 2 this r ;clay of 'M(t tuL *— 20 Eby (Namepf person acknowledging) „ 'y ature of Notary Public- State of Florida Personally Known �©R Produced identification Type of identification Produced Commission No.l�� ;�� (Seal) Revised 07/15/2014 STATE OF FLOrM COUNTY OF � FRONT ZONING SUPERVISOR The forgoing instrumentwasacknowledged before m , � this ° -bay of p ° 20 f-- by & Q Q COUNTER REVIEW REVIEW (Name of rson acknowledging j` REVIEW REVIEW ��►► DATE gnature of N LaryPubllc- State of Florida Personally Known Oft Produced identification Type of identification Produced Commission No,,Kf `YS-1� (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS