HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR:
Address:03 `,m it c+(e r
Legal Description: ^T Y1 Cit Q`� P" --g , �S
Residential
Property lax ID #: 001y �- d 9 a- o a a- Lot No.
Site Plan Name: Block No, (-
Project Name:
Setbacks Front Back: Right Side: Left Side:
Aaamonai worn to tie pertormea unoer this permit– cnecK aii tnat apply:
_Mechanical — Gas Tank _ Gas Piping — Shutters _ Windows/Doors
Electric Plumbing —Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ MoOQ
5q. Ft. of First Floor:
Utilities: _5ewer —Septic Building Height:
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Code:
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Phone No.
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Fill in fee simple Title Holder on next page if different
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from Owner listed ■ ■County
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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OWNER/ CONTRACTOR AFFI))%gT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work, or installation has commenced prior to the issuance of a permit
St Lucie Counter makes no representation that is granting a permit will authorize theermit hoiderto build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or angcovenants 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 aa=dance 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,
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another non-residential use
WARNING TO OWNER, Your failure to Record a Notice of Commencement may result in your paying t ice for
improvements to your properly. 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
commencine worst or recordinR voor Notice of Commencement. ._._ . n ---_._- .
as Agent for Owner 15'tg�a ireof Contractor/License Holder
STATE OF I^LORIE?ASTATE OF FLORIDA
COUNTYOF f1�iG�►-� l i+'r---- COUNTYOFrZt1���� - 9.,.nc _ --
Theoiriginstrume twas adcnowledg di before me
this dayof (— {``�Aby
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
The fo oing instru ent was acknowledged before me
this day 2f7 I by
` )
Name of person making statement.
Personally Known Z_OR Produced identification
Type of identification
(Signature of N 0
-1~ a
Pamela
Commission No._a 'mac
FiarWa
REVIEWS COR NITER REVIEW SUPERVISOR I ZONING REVIEW REVIEW REVIEW SEATURTLE REVIEW I PREVIEW E
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
EEE SIMPLE TITLEHOLDER:
— Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone;
Zip: Phone:
OWNER/ CONTRACTOR AFFI))%gT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work, or installation has commenced prior to the issuance of a permit
St Lucie Counter makes no representation that is granting a permit will authorize theermit hoiderto build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or angcovenants 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 aa=dance 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,
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another non-residential use
WARNING TO OWNER, Your failure to Record a Notice of Commencement may result in your paying t ice for
improvements to your properly. 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
commencine worst or recordinR voor Notice of Commencement. ._._ . n ---_._- .
as Agent for Owner 15'tg�a ireof Contractor/License Holder
STATE OF I^LORIE?ASTATE OF FLORIDA
COUNTYOF f1�iG�►-� l i+'r---- COUNTYOFrZt1���� - 9.,.nc _ --
Theoiriginstrume twas adcnowledg di before me
this dayof (— {``�Aby
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
The fo oing instru ent was acknowledged before me
this day 2f7 I by
` )
Name of person making statement.
Personally Known Z_OR Produced identification
Type of identification
(Signature of N 0
-1~ a
Pamela
Commission No._a 'mac
FiarWa
REVIEWS COR NITER REVIEW SUPERVISOR I ZONING REVIEW REVIEW REVIEW SEATURTLE REVIEW I PREVIEW E