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HomeMy WebLinkAboutBuilding Permit ApplicaitonALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: Building Permit Application Planning end Development5ervlees Building and Code Regulation Divlslon 2300 Virginia Avenue, Fort Plerce FL 34982 Phone: (772) 462-1555 Fax: (772) 462.1578 PERMIT APPLICATION FOR: Address: Legal Description: a Cl. Commercial Residential To Select from dropbox, click here DCATfiN [ LaA 0. 1h0- - Vlu etitp— cz- Property Tax ID #; ` `l C (� 3 (r o o C ~ t, Lot No. c Site Plan Name: - Block No, Project Name: Setbacks Front. Back: Right Side: � Left Side: ©ETAiIEDt)'SCRiPTIC3IV OF WORK'-, is - r; COI�ST�tUbTj)d l# FORMATIt]N.: t ona wor a e ie orme un era a . pP Y: HVAC Gas Tank Gas Piping Shutters Windows/Doors Electric � Plumbing OSprinklers Generator Roof Total Sq. Ft of Construction: Sq. -Ft. of First Floor: Cost of Construction: $ i t 2 - Utilities: SewerSeptic Building Height: Name �l s�_.� (�i+�,, Address: 1� - - City:7f State. F -L- ZIP Coder y Fax: Phone No, E -Mail: `1 Fill in fee simple Title Holder on next Page ( if different from the Owner listed above) if Name: QtJ R4 JA Company: at P- Jr3 ���t�C•��r�C � l�f� C'i'�i Addreessss:� , C �e City:; GuClf State: Fl-- Zip LZip Code: 3f Fax: 77.2 -67/ CF&e Phone No. State or County License:./ t[[ — _ j Is $2500 or more, a RECORDED Notlee of Camrnencement is required, fl — Not Ap MORTGAGE COMPANY' � Not Applicable Name: Game: Address. Address: City, Mate: City: State: Zip: Prone: Zip: _ Phone: RE 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, 5t. Lucie County makes no representation that Is granting a permit will authorize the permit holder to build the subject structure which is in conflictwith any applicable Home Owners Association rules, bylaws or andcovenantsthat 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 ail respects, perform the work in accordance with the approved pians, 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 Niotice 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 a first Inspection. If you intend to obtain financing, consu +e,A�aitorney before corr1Ci' encl a 17gQrIG or recortaln ur Notice of Comrnencem \--. ---_-._-- 5igriature of:Owrier/ Lessee/Agent. STATE OF FLORIDA COUNTY' OF! � L UC i ca wh The for Ding instrument was acknowledged before, o thisay of '20 Eby . D� �W T. (Nan7ep person acknowledging) 4 ,-� N State of Florida Signature Personally Known OR Produced identification Personally Known �t}R Produced Identification Type of Identification Produced _ _-- Type of identification Produced Commission No. 4 (Seal) Revised 07/15/2014 Commission No. {Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW 'REVIEW BATE COMPLETE INITIAL$ R 11 c COUNTY OF The forgoing instrument was acknowledged before m, The this By of S - 20 by Q ___. CAn 2M (fume of rson acknowledging) WIN.- ( griature of N tory Public- State of Florida) Personally Known OR Produced identification Personally Known �t}R Produced Identification Type of Identification Produced _ _-- Type of identification Produced Commission No. 4 (Seal) Revised 07/15/2014 Commission No. {Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW 'REVIEW BATE COMPLETE INITIAL$