HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
_ Not Applicable I MORTGAGE COMPANY: — Not Applicable
Name:
State:
_ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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, 1 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 the first inspection. If you in;fnd to obtain financing, consult'th lender or an attorngg before
coin irk en work or recording vo vy
,/
Notice of Commencement% 7 1 A A
as ARedd for Owner
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF =`1-4 -;—)c ✓Cy' 1COUNTYOF —7— nc� a � ✓e �-
The forgoing instr ent was acknowledged before me
this %&day of Lw" 20 iQ9 by
(Name of person acknowledging } �,
The forgoing instrument was acknowledged before me
this day of , 20 by
(Name of pers9A-4ckno$vledging) �1
(Sign tqA of"Notary Public- Stye-ef'Florida) % (Signa ure Notary Public- State of F ri )—
Personally Known OR Produced Id ntific 'on V Personally Known OR Pro u Ide •c i
Type of Identification Produced L� Type of Identification Produced
.-Z
Commission No. mmission No. (Seal)
y.PyB,, PAGE L. J RRIEL
commission # FF 968344 ARRIEL
a= Expires April '`°__ Commission # FF 968344
ReVlsed07/15/2014 Bonded RruTroy Fain insurance 800.385.7019
` Expires April 14, 2020
Bonded Nu Troy Fain insurance800.385.7019
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
ALL 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) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description: V ) �� (' -� L. Lk ! G�
Property Tax ID #: OH4-& - I C,' > • (-Jp' -p 1 • C"C)G . S Lot No. I
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
1]HVAC
11 Electric
t `_'.I Plumbing
Sprinklers
L_J Shutters
Generator
Block No.
QWindows/Doors
0 Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1� Utilities: Sewer F]Septic Building Height:
Name
Address:�� s n
City: �� I - State: �(
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Roof pitch
Name: I a-r{ & r
Company: H 4 ID (Gt art be r�
Address: 4 ' `ib c'
City: l-a It C State: L
Zip Code: iloa Fax: 1%Q �y1b t�rkS2
Phone No. `1`1� �79 '-3 1r7 ("
E-Mail: ht) i f /
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.