HomeMy WebLinkAboutBuilding Permit Application _ DATE FILEI9:
PLAN REVIEW FEE: RECEIPT NO.: p PE�I MBER:
CONCURRENCY FEE: = RECEIPT NO.: CERT:'�AP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
= PLANNING&DEVELOPMENT SERVICES DEPARTMENT
:M BUILDING&CODE REGULATIONS DIVISION i
2360 Virginia Avenue
Ft.Pierce,FL 34982-5652
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS:
2. PROJECT NAME: SITE PLAN N
3. PROPERTY TAX ID P
4. LEGAL DESCRIPTION(attach extra sheets ifnecessary):
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO.
9. PARCEL SIZE(ACRES/SQ FT.): y Z LOT DIMENSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: rc
02 e,
11." SETBACKS(ACTUAL) FRONT: S� BACK: I RIGHT SIDE: 1 ja !CLEFT SIDE: '97
12. TYPE OF CONSTRUCTION(Check all appropriate boxes)
NEW CONSTRUCTION [ j C SIR��DITION [ I INTERIOR RENOVATION
RESIDENTIAL [ ] .INDUSTRIAL
[ ] OTHER(SPECIFY)
13. DESCRIPTION OF PROPOSED"USE: c�•z
14. SQ.FT OF CONSTRUCTION: 15. SF.1-T"1st FLOOR
16. VALUE OF CONSTRUCTION: $
The value of construction is used to determine the amount of permit fees to be assessed. St Lucie County resen es the right to question and/or modify the indicated
value of construction if itis demonstrated that the submitted figures are not consistent with similar types of construction activities. if the valuois$2500 or more,a
RECORDED Notice of Commencement must be submitted with this application. ,
5LCCDV Form No.:001-02 '
i f
UPDATED 6125109