HomeMy WebLinkAboutBuilding Permit ApplicationALLAPPLICASLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; �dfiat{
Permit dumber:
P1017ningand Developm4antServlces Building Permit Application
Building and Code Regulatlon Division
2300 Virginia Avenue, Fort Pierce FL 349,92
Phone: (772) 462-1553 Fax: (772) 462.1578 Commercial `
PERMIT APPLICATION FOR; T------ �esi�entiai
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#�RO`pSE� INPDUEMENT f:QCATi.ON;�
Address:
Legal Description: �� } c� ! ev C e ,
Property Tax iD #:
Site Plan Name., Lot No. {
Project Name-
Setbacks
No,
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Setbacks Front-- _�� Back:
----Right Right Side: Left Side:_
DETAIIwI=D°D SCRIPTI4N 4FWORK',:
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CONSTRUCTION LNI+ORMATION:.'
t ono wor o e e orme
�`� un ert sperm - c ec a
LIHVAC Gas Tank aAp Y•
QGas Piping Shutters (�
I� Electric � Plumbing �� rinkie � Windows/Doors
p rs �1 Generator C1 Roof
Total 5q, Ft of Construction:
Cost of Construction: $ GZi S Ft of First Floor:
_LLLI= 1- _ .tilities:]SewerLSeptic Building
�°WN°�'RjLI=SSEE, _... _ Height: -
Name a,r�mi k
Address: , tG
City: J c U '
State:
Zip Code: ��.
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Phone No, - 28 -
E-M.a il:
Fill in fee simple Title Holder on next Page if different
from the Owner listed above)
If value of construction is
Name: bA
Company: bt (e�6,4 � pjee
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Address: SC atiec) M ;e.r56`
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Zfp Code: 2!Lc{•�"�� State: FL
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Phone No. 7/ ` fax: 77a -g71 �g(�
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State or County License:
or more, a RECORi3ED IVatiCe of Commencement is required. 11
Not Ap
Name:
Address:
City: _ State:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City:. State:
Zip: Phone:
PEE SIMPLE TITLEHOLDER: HOLDER: _-:-_Not Applicable I 13ONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address;
City:
Zip: Phone:
I certify that no work or Installation has commenced prior to the issuance of a permit.
Sl. Lucia County makes no rep resentation that Is granting a permit will authorize the permit holder to build the subject s 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 wont
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 usesto 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
beforeigfirst lnspection�If you intend to obtain financing, cons ultm#M endeF Q44n attorney before
SlgnaCure of:Ownerl Lessee/Agent+
STATE OF FLORI A
COUNTY Of_!S:1_„UC _ E!
The fargaing Instrument was acknowledged before rw
this day of _1210C, . 20 j2..by aS ' a
person
ry Public- State of PI
STATE OF FI'0 r � g
COUNTY OF
The forgoing instr ent was acknowledged before m,
this _±day of ^ Tmi L — -, 20 11 by �t 2
a
.1 id -A
(Name of gdrson acknowledging
re of Nr6tanr Public- State of Florida
Personally Known OR Produced Identification Personally Known L,- OR Produced identification �I
Type of Identification Produced Type of Identification Prod�ucced,
Commission No: (Seal) Commission No. 7 (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER I REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
COMPLETE
INITIALS