HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY Th
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
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Address: qç ect. -Th onSn 3cqs)
Legal Description:
PropertyTaxlD#: Lkt3_Lc(._5O.Sfl - Lot No.
Site Plan Name: 1k LLCt '-P Y'Y1L)\.) Block No.
Project Name: S
Setbacks Front Back: Right Side: Left Side:
ILTA LED DES€RIPTIONPF2(0)fl
GONSTRU@TON NFORMk'ON 1Z
.'it na wor to •e
VAC
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Gas Tank
is permit —c ec a
Gas Piping
ayppy:
'Shutters E1Windows/Doors
Electric F] Plumbing IlljSprinklers [1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S. Ft. of First Floor:
Cost of Construction: $ üô Utilities: Sewer Building Height: _Septic
.OWN ER7J!ESE E : tThTRrGtR ttW:S-4
Name
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OWWWWWWOMINIM Name: t LI
Address: S?Dh SOQt&n D(UW1O3 CompanyJr&fluJAfj CIOQlE l
City TQX\ statec{ Address: t3 9Dfl Ui Lk s -
Zip Code: Fax: City: I1iL.X._VTh State: yC{
Phone No. - (&nst 3 Zip Code: 3332-S Fax:
E-Mail: Phone No. Cf
Fill in fee simple Title Holder on next page (if different E-Mail: I kCiVi r, eOM
from the Owner listed above)
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State or County License: 0033 \
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SVLEMENTAL€ONSTRUG11ON NQJ1j-' INFORMA"
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DESIGNER/ENGINEER: - Not Applicable
Name:
MORTGAGE COMPANY: - Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: - Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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.
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 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 a Notice of Commencement may result in your paying twice for
improvements to your prop- y.A Idtge of Commencement must be rec. rded and posted on the jobsite
before the first inspecti.'. f y u tep'd to obtain financing, cons it 'e der or an attorney before
commencing work or - - cordi /Notice of Commence en
Signature of 0 ractor as Agent for Owner p of Contractor/License Holder
STATE OF FLOR
COUNTY OF .1 A A
STATE OF FLORIDfr
COUNTY OF
The forgoing instru ent was cknowledged b fore me
this2 day of d'1t&'Qs* , 20 j/by
The forgoing instr ent was ac nowIedgeiefore me
this day of' 20// by
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(Name of p - son acknowle. : :
,1-,I,./Iv (S:nature of ¼1 Public-S :,4c&a'40
(Name p- on acknowledgin:
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(Sh ature of NVPublic State ofF • r
- . a y 'n.'; 4ion Personally Known
Type of Identifica •n 1'Vt 5.0' Type of Identific.-- • ':n4tct0
:'?sc- iciA - . 5,
Commission No. " .P (Seal)
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Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS