HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Punning and Development Services
Building and Corte Regulation olvision
2300 Virginia Avenue, Fort pierce FL a4982
Phone: (772) 462-1553 Fax: (772) 462.1579
tbmmerciai R�sidentlal
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSt*D INPR(JVENIENT LQCATI;4N, p
Address; Ji 't r� v
Legal Description: f 1 t }.�. J�� Gam'
Property Tax I #:
Lot No.
Site Plan Name: Block No.
Project Name-,
Setbacks Front_— _ Back: _ Right Side: — Left Side:
AILED. tSCRIPTfON OF lC#RK
-f.
Q C Imo-
v
CONST tUCT�ON.i.NFQR�MATION:
.
tiona wor o e e orme un er
0HVAC Gas Tank
sperm —c ec
❑Gas
an�]5i_appy:
�Electric
Plping
1 Shutters
Windows/Doors
4Q Plumbing
Sprinklers
Generator
Roof
Total Sq, Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ � " Utilities: Sewer El
.w
Septic
Building Height:
Name --1' -4",C
Address: r t'
City. 15z_-)J I e r (e' 5tat.e: [�
Zip Code: If Fax:
--
Phone No,
E-Mail:
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
If value
Name: N AA r 14A)b-A
Company:
Address: 5G' Ark 1107-AP,_0156- b,er
City'°_r � Lr� c� c
State:
Zip Code:.31 _ Fax: '17a `6 71 OTrog
Phone No. %�X - ??e-
E-Mail.
State or County License: l
Is $2500 or more, a RECORDED Notice of Commencement is required,
Not
Name,
Address:
City: State -
Zip: Phone:
FLEE SIMPLE TITLE HOLDER: _,__Not Applicable
Name;
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City:. _ State;
Zip: phone:
BONDING COMPANY: Not Applicable
Name:
Address;
City;
Zip: Prone:
i certify that no work or installation has commenced prior to the issuance of a permit.
st uc a County male no repress ntation that is granting a permit will aue orize the permit holder to build the subjects tructure
w#�chs In conflict wtt any applica is Horne Owners Association rules, by aws 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 addltions,
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
befor�flrst inspection If you intend to obtain financing, consume -ice .attorney before
griature of:0'wnerf Lessee/Agent
STATE OF FLO IpA
COUNTY OF s ~`
The forgoing instrument was acknowledged before rd
Q:96
this 'day of ' 2Q j_qlry
r,
a Rik
(Name I person acknowle ,-sing) .4,4 _
Personally Known �OR Produced Identification
Type of Identification Produced
Commission No. (SCSI)
Revised 07/ I5/2014
STATE OF fii.ORss
!—ICOUNTY OF c
The forgoing instrument was cknowledged before m ;
this ! slay of Ii %`� AV �P.2 .20 _L2 , by
1-. a :5
Personally Known f%�QR Produced Identification
Type of Identification Produced -�
Commission Nm `F `7"7 � d �'J (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS