HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date, __ iv o � �
Permit Number:
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Planning and I]evelo pment Services Building Permit Application
Bu!laiing and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462.1553 Fax: (772) 462-1578 C`bmmerdal /
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PERMIT APPLICATION FOR: To Select from dropbox, click here
PRaPDSEDiIN-17RQVEM-NT'�.QCATION.
Address. -
Legal Description:
I
Property Tax ID #:
Site Plan Name: Lot No.
Project Name: Block No,
Setbacks Front__. Back.- Right Side: Left Side;
DETAILEbtl), SCRIPTI4N OF 1NORK;:: `
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'0401(1 t�),In A 6I AAA � It P�: _� FI BRA if l n � _ ti.�
r t s nerm' ox
HVAC Gas Tank uGas Piping
Electric Plumbing OSprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
aPp V•
Shutters D Windows/Doors
Generator 0 Roof
S Ft. of First Floor:
Utilities: []Sewer[ -]Septic Building Height:
Name
Address:
City: /tit,! A, 1T�� State:
Zip Code: Fax:
Phone No.
E-Mail:.
Fill in fee simple Title Molder on next page i If different
from the Owner listed above)
If value of construction is
Lid.iI4N-MAI:I-U.i`� - - -
Narne.—J20ry A,1 (g 4 jA
Company: ti!!P-6,4
Address: .SO AeZ
City: fir i Luc /
State:
ZIP Code: 2, Fax: i7
7 / 7 ?&d
Phone No %��- �7�.- ,�'/a,..�
E-Mail. 0 _ Ct rm iy4 rat,
State or
�� .., ,.,
County License; � _t- C J
or more, a RECORDED —Not—lee of Commencement is required.
Not
Name:
Address: State:
City:
ZIP: Phone:
FEE SIMPLE TITLE HOLDER' � Not Applicable
Name:
Address:
City:
Zip: Phone`
MORTGAGE COMPANY: __ Not Applicable
Name:
Address, State:
City:
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 Counttyy makes no representation that Is granting a permit will athorize rhe9er it holdants ha mays the
subject
u olr prohibit such
which is In confkict with any applicable Home Owners Association rules,bylaws
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply..
In .in consideration of the granting of this requested permit, I do hereby agree that I accordance with the approved plans, the Florida Will,
respects, perform the work
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, wails, signs, screen rooms and accessory uses to another non-residentlai 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 ton he jobeforbsite
before first ins ection. If you intend to obtain financing, consu Y
, enr� r �r rprnr i ur Notice of Commencem
_ Signature af'Ourrner/ Lessee/Agent
sTATE OF FLORIDA'
COUNTY OF .4-'�— as
The f rgoIng instrument was acknowledged before r
this day of G 20 Zo_by W J@
Ca l� �1'' 11 1ti--•r�ft ����tlllFllil��
(Name # person acknowiedling )
( i5(g ature of Notary Public State of Florida )
Personally Known OR Produced identification
Type of identification Produced
ComrnissIon Nu.r-
`� 15ea1)
Revised 07/15/2014
STATE OF FLOR 1 "" _-�J
COUNTY OF `
d
The forgoing ins=,k
cknowledged before m �,
this&ay of2� Z� by -S
l� __ m
of q�rson acknowledging
o�ta' Public- State of Florida j
Personally Known L,- OR Produced identification
Type of Identification Produced
Commisslon NaJC'r— QvEz % (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS