HomeMy WebLinkAboutBuilding Permit Applicatiion&Li u-vUO.
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Site Plan Name: Lot No.
Protect Name: Block No,
Setbacks Front___. Back:
-_._.._.__....r Right Side: Left Side:
DETAIIEDD[+SCRITIOt. 0 1IOAK;
jet,ck
5 it C
t- l` q
HVAC
Electric
� 5 oerrr� ••.r or .. _ - -
L� Gas Tank Gas Plping
Plumbing
.JSprinkirs
Total Sq. Ft of Construction:
Cast of Construction: $ i C
ALL APPLICABLE iNFO MUST BE COMPLETED FOP APPLICATION TO BE ACCEPTED
Date: �i�
Permit dumber:
Building Permit Application
Planning ar�d Development Services
Building and Code Regulation ❑lvision
2300 Virginia Avenue, Fort pierce FL 3.4982
Phone: (77Z) 462-1553 Fax: (772) 462-1578 Commercial '
Residential
PERMIT APPLICATION FOR: To Select frOM dropbox, click here
PRDPi S£D'INIaR EIVI:ENTIOCATi3ON. f; �G . �-1 to vl
Address: If, N(. -,41 �'v � U-e, ; 4tti
Legal Description:
Property Tax ID #,
Shutters Oftdows/Doors
Generator C] Roof
S Ft. Of First Floor:
Utilitles:'nSewer LJSeptic Build
ing Height:
..
Name Vv Sf"
Address:
City., at
ZIP Code: 4i state:L.
Fax;
Phone No,
E-M.alk ,4
Fill in feesimple Title Helder on next page ( if different
from the Owner listed above)
If ualbe of construction is $25a0 or
Name, 4rV JA
Company: tit ��.�C �- RIP 6,41A
Address:
City: raid � r
i CLu•c�r�
Zip Code: 3� �� F State; 9-1-
Phone No. �7,�=----_._ ax; 77a
E-Mail.L�id�
State or County License: C I j
more, 8 RECORDEp Notice of Commencement Is required, .11
Name:
Address:
City:
Zip: Phone:
State:
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
Name:
Address:
City.
Zip: Phone:
l certify that no work or Installation has commenced prior to the issuance of a permit.
St. Lucie Count�yy mit
ak 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 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 first ins ep ct1p_n. �# you intend to obtain financing, consul -lee€ n attorney before
co=enc€ r or recordiY��ur Notice of Commenceme�
_ Slgriature'of'Owner/ Lessee/Agent m = .
STATE OF FLORIDA s �'
COUNTY OF !S1I_
The forgoing Instrument was acknowledged before Q
this �-�lay of—
.,_Z4 4by ig 4 'g
M11'SI; All
(Name ! person acknowledging)
'(Signature of Notary Public- State of Florida
L/�}
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. EE `�_/ _7 (Seal)
Revised. 07/15/2014
STATE OF FLOR r
'
Q z,
COUNTY OF �S -.
The forgoing instrument was acknowledged before m,
this 1, day of 20 by
oie
r�
on acknowledging)
Agnature
N tary Publio-State of Florida)
e,��*���•�
Personally Known C/•�OR Produced Identification
Type of Identification Produced
Commission No., WV(� (Seal)
REVIEWS
FRONT
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ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
lN1TIALS
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