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) 462-15553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line .
Address:
Legal Description:
K-3
Property Tax ID #: lD
Site Plan Name: G
Project Name:
Setbacks Front Back: Right Side: Left Side:
Ej Plumbing
U 5prinklers
Lot No.
Block No.
JA_: A, 3 S-Ae
71
L �l Shutters
Generator
E]Windows/Doors
0 Roof
Total Sq. Ft of Construction: ((�� 5 Ft. of First Floor:
Cost of Construction: $ ��`T'� t O D Utilities:ll Sewer Septic Building Height:
Name I I \ 114
Address:
City: 7:��__ State.
Zip Code: Fax:
Phone No. � 1"
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
Name: _k- L•_(J`�.f,,nftLl�n
Company: 62w, 'A -t�U l_.tWl' C,uTLI
Address: 5*0 IC—
City: l State:
Zip Code:M3-'�r S Fax:
Phone No/. �—
E-Mail: `PX1 ,
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGN ER/ENGIINEER: _ Not Applicable 1 MORTGAGE COMPANY: Not Applicable
Name:
Name: _
Address:
Address:
City:
State:
City:
Zip: Phone:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: _ —
City: City:
Zip: Phone: 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 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, 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 ailure to Record a Notice of Commencement may result in your paying twice for
improvements to your pro . A Notice of Commencement must be recorded and posted on the jobsite
before the first inspecti . If y u In
to obtain financing, consult with lender or n attorney before
commencinp,YTo- k o ordi your Notice of Commencement. I
Signature
STATE OF Fi
COUNTY OF
as Agent for Owner I Signature
The fff��rgping instr ment was acknowledge efore me
thisCi -1 day of 20 by
Name,of erson acknowledging }
{Signature of Ngt'a'ry Public - State of
ers ally Known 0
Type of Ide ion P
Commission No. to
Revised 07/15/2014
nse H
STATEOF FLO COUNTY
�
couNTY of
The forgoing instrument was acknowledged b fore me
this—Qgdayo#Y 20 by
(Name of person acknowledgirLg,f
re of NCtWPu1Ylttc- State of Florida )
Personally Knowd OR Produced Identificatio
T e of Identifica ' Produced N&cpN_,RERG
,,Hrlrrrr I�T� gq�# FFr 9354V
Commission No. : Com!m Al. 2�18
REVIEWS
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ZONING
SUPERVISOR
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VEGETATION
SEA TURTLE
MANGROVE
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REVIEW
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DATE
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INITIALS