HomeMy WebLinkAboutBuilding Permitting ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY
I 0 A
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 Residential
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
101 0 ElMP'® E t:t
Address: S -
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- Legal Description: zL-s\iui\d'to COK(
Property Tax ID U: L.cr5 -(jX'ja-O I-1~1 3cD3 —'.7 Lot No.
Site Plan Name: 9 Q O 72 It Block No.
Project Name: V
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Total Sq. Ft of Construction: S . Ft of First Floor:
Cost of Construction: $ S"t C) C) Utilities: OSevver riSeptic Building Height:
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Name I 4 R67 7 Name: iPTj J
Address: SUflSO I $ 'D.T Company: ftiA (1.' t
City: State$C.. Address: \3 W 11 Ui LI. S4r
Zip Code: ,3L\S) Fax: City: .5LL.c\ C State:
Phone No. ("\3 41 Ii tO Zip Code: 333'3 Fax:
E-Mail: Phone No. .s*k 0TG SStk (4
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License. C'rOO
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: - Not Applicable
Name:
MORTGAGE COMPANY: - Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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
ntl which is in coict with any applicable Rome 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.
Inconsideration 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 exemptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sighs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your fail - o Record a Notice of Commencement may result in your paying twice for
improvements to your . . Notice of Commencement must be recorded and posted on the jobsite
before the first inst -ction • intend to obtain financing, consult with lender o an attorney before
commencing w., or re'. g your Notice of Commencement.
Signature Own-
LJFJFLORthPaUjJ.I4
, 'Th/Contractoras
elliop
Agent for Owner Signature o"ctor/License Holder
btr4cri'z uJord
The fqçgoing insjgment as acknowledgedj bjfore me
thisdayofCC4 (J 20 4.4by
The foçyoing instrume9t 1as acknowledge fore me
this /(JJdayoiT1ii4 (3 ,20 I I by
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(Na of'. -rson acknowl ) (Name of rson acknowledgin
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P - sonally . • :A . iced Identifica ion Personally Kno OR Produced • on
Type of Iden - •.• . Type of Identific tion Prod -,
Commission No (Seal) tft';C
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Revised 07/15/2014
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS