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Building Permit Application
Al .OMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: Planning and Development Services Building and code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: PROPOSED iNPROVEMENT LOCATION: Address: Property Tax ID # Site Plan Name: _ Project Name: r) !0— Building Permit Application Commercial Residentia e- C -4 J_' Lot No._ Block No. CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: l�_Mechanical _ Gas Tank Gas Piping — Shutters Windows/'Doors Electric _ Plumbing Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: t Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Nam „ 9CYI �C.fi1 +(1 Name:, C Add Company , CA- v D- t U City:Statet Address: - Zip Cod • Fax: � � ,`" City: � i�l�C State: FL 4 11 Phone No. Zip Code. 30qffo Fax: E -Mail: Phone No Fill in fee simple Title Holder on next page ( if different E -Mail CLQ from the Owner fisted above) State or County Licenser N 4 01~ If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER, _ Not Applicable Name: Address: City: - Zip: Phone; MORTGAGE COMPANY: Not Applicable Name. _ Address: City:State: Zip: Phone: BONDING COMPANY- Not Applicable Marne., Address: City: Zip: Phone, I certify that no work or Installation has commenced prior to the issuance of a permit. 5t. Lucie County makes no representation that Is granting a permit will authorize theermit holder to build the subject str ct which Is in conflict with any applicable Home owners Association rules, bylaws or andcovenantsthat may restrict or proh[bi# such structure. Please, consult with your biome 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 ail 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 roust be recorded and posted on the jobsite before_jbp first ins colon. If you intend to obtain financing, consul ander-o.r_ aitorney before co_ enci r c or recor i ur Notice of Cornrnencem \ Sigriature of'flwner/ Lessee/Agent r� ffis L�. STATE OF FLORIDA COUNTY OF � I �g The r oing Inst entw acknowledged, eforen s is this day of ZOa 82 by . 49 ,���tl4i1ii1l,�� (Name j person acknowiedging) .4 � ]l c- State Signature of Contr�torlpcense STATE OF FLO#i L3., COUNTY OF - i-' Ga Q The for oing instr meat w s acknowledged before m 1,w I Q this `day of 20 , 2! (Name of pgrson acknowledging) of Nttafy Public- State of Florida Personally Known L"�OR Produced identification Personally Known is" L3R Produced Identification Type of Identification Produced Type of Identification Produced Commission No.ft � t (Seal) Revised 07/15/2014 Commission No. - MI (Seat) REViEWS FRONT ZONING SUPERViSOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ©ATE COMPLETE INITIALS