HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY
R 1 0
- 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
1j)'® ED) 1o'IM•-i C4A TC
Address: 6 n itt CUY-.-P
Legal Description: III _A\C4C) 3* VTh
Property Tax ID It: Lot No. \ )
Site Plan Name: EC'%\(3SLj.&..... Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Gas Tank [iGas
ispermit—c ec a m
Piping -
appy:
Shutters Li Windows/Doors
Li Electric S Plumbing EjSprinklers I ....jGenerator I I Roof Roof pitch
Total Sq. Ft of construction: S Ft. of First Floor:
Cost of construction: $ _qRS.3 O UtiIitiesSewer [iSeptic Building Height:
Name 1. Name: SIlTS
Addp.: 1¼ L9Ve1u company: &36
City: &t?r I State: L Address: I S
Zip Code: 3k Fax: City: R JJTh (\ S State:
Phone No. T- s~-sg' CRJD Zip Code: 3339- T Fax:
E-Mail: Phone No. tk2 -çt_j Uj
Fill in fee simple Title Holder on next page (if different E-Mail: ' ctsen'O.o (7q ot 'A--\-a. A-\ r eo
from the Owner listed above) State or County License:
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: - Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: - Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: Address:
City: City:
Zip: Phone: 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
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants
structure. Please consult with your Home Owners Association and review your deed for
In consideration of the granting of this requested permit, I do hereby agree that I will, in
in accordance with the approved plans, the Florida Building Codes and St. Lucie County
The following building permit applications are exempt from undergoing a full concurrency
accessory structures, swimming pools, fences; watts, signs, screen rooms and accessory
WARNING TO OWNER: You failure to Record a Notice of Commencement may
improvements to your pn erty. A Notice of Commencement must be recorded
before the first inspec ' F. If you intend to obtain financing, consult w -
ording your Notice of Commencement.
holder to build the subject structure
that may restrict or prohibit such
any restrictions which may apply.
all respects, perform the work
Amendments.
review: room additions,
uses to another non-residential use
result in your paying twice for
nd posted on the jobsite
I - . ran attorney before
Signature jY"t r essee Contractor as Agent for Owner Signaturr • ontractor/License Holder
STATE t FLRI'A i i ¼ jj 4
COUNTY OF
STATEOFFLdiIDy1
COUNTY OF Di o u-..._v'- I
this
The forgoing instrymt qcknowledge4 efore me
4 day of \7'-N_LI (V'— 2Oflby
The
this
rgoing instrument w,anowledgebfore me
day of \A.ftL1U LL..A' ,20 (jby
(Name oL3Prson acknowled,flig) (Name of 'ers. acknowledging)
saL X 0A 4i7L ia' 40t
(Sa IF ur-. &Vub -. ate of Florida) (Sigratur of NotaDii ta
ersona!Iy Known OR Prod -. Iden ication Personally Known ..'"?'Q • r 'nti '1$..z -14
Type of ldentificatio. Produce. Type of Identificat '.r r W'
Tto
Commission No. .0 Commission No. tcc" (Seal)
Revise
'I
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REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS