HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-ment
Building Permit Applicatiion `)eD3�'
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
Legal Description:Qty P ?:r)C_S (.6+ (3q (K-k
Property Tax ID#: 2L4(3 Lot No. l 3'4
Site Plan Name:'" Ct �(*7_ Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
O'x' so_ cw-+_- O(60:n RC&--) oo S"L-Le-CkNCnbP-- /"J00 PV_-r 4"r
Additional work to be e ormed under this permit-check al that•app Y:
FIVAC Gas Tank F_]Gas Piping FIShutters FlWindows/Doors
7 Plumbing Flprinklers F1- F] 20-0 rs Electric Generator Roof
Total Sq. Ft of Construction,: Sq. Ft.of First Floor:
Cost of Construction:$ j7Q9,55 Utilities:F]SewerF]Septic Building Height:
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Acldress:C,295 D,'clL�5 o,, _'k-( i-Al OC'k Q*e k:�_yc
s c,< vas-r- Company'. -T
City: P6't aa_']�E Q, Stater Address: 1,2,q (Q, t -79 Tf-I Ozfi2
Zip Code: �ZcI47 Fax: City: 10, lf-17�j kyvi_�C-t 0_1�--_ State:-F—"-
PtioneNo. Zip Code:3'_:)1iA I �_— Fax:-tr4l a5S_-
E-Mail: Phone No. t- '3-5757
__
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License; C.c
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNERjENGINEER: ___ Not Applicable MORTGAGE COMPANY. ____Not Applicable
Name: Narne:
� Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 confiict 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
com I work or recording ou otice of Commencement.
t_rt�r
ignature of Owner/Lessee/ gent i tur of Contractor/License Holder
STATE OF FLOg�Dq STATE OF FLO D
COUNTY OF �s`r G-v�t �% COUNTY OF �Y1r� &PaCh
The fA°�r oing instrument was acknowledged before me The far oin g instrument.was acknowledged before me
this�day of zd 20 4by this 6g day of C 20 �by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) J 4(S!ig*nae Not P=OR
of Florida)
Personally Known OR Prod�u9ce�pdtll,d��e99ntific/�tin X Personally Known oduced Identification
Type of Identification Produced CA /11- ^ r"' ,n—SG Type of identification Produced
Commission No.
ea mmission No. tom'Aua�, (§R.- YauNo
Joshua DeVoe MY COMMISSION#FF 951069
MY COMMISSION#GG3176 5Mai
m
o;F1' �FOF f4nQ 80WO Thru OWN NotwyServims
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER i REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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