HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
® ly
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
Rfl,ifL, r
Address
Legal Description: I,��NyA0Q*0AJ' (QrO�O (I UYALk (ZQq _
Property Tax ID #: ✓� Vd✓?7 by ^Q� — Lot No,
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing []Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction:
Cost of Construction:
S Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
Name
Nameo:Ta)o NIP
Addres
s DCer� r • J
Company: w6 &
C�1
Address:
Ofv
City:
Zip Code:34553
Phone No.
_
Fax:
State:tiL-
City:
Zip Code: 1945r Fax:
No:
Phone No. aV � '9
State:_
29� ZSi2_
E-Mail:
E-Mail: �S e(�
r %)in✓'1
Fill in fee
from the
simple Title Holder on next page
Owner listed above)
( if different
State or County License: 3r (3f
f 527 ? Z ss
If value of construction is 5z5ou or more, a ntLuttucu rvouce or �ommencenrcm IN iryuiic.,.
Name:
Addres
City: _
Zip: _
Phone:
State
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
Address: _
City:
Zip: _ Phone: — ___
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: _
City: State:
Phone:
BONDING COMPANY:
Name:
Address: __
City:
Phon(
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please (on su It with your Home Owners Association and reviews your deed for any restrictions which may apply.
Inconsideration
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
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory us
WARNING TO OWNER: Your failure to Record a Notice of Commencement ma
improvements to your property. A Notice of Commencem6'nt must be reco
before the first inspection. If you intend to obtain financingu,'.,consult with le,
commencing work or recording your Notice of Commencement.
as Agent for Owner
STATE OF FLORI STA
COUNTY OF__• , I yY�--_ { COL
The fogiRg instru ant wad knowledge afore me
thislQ day of 20by
Personally Known � OR Produced Identification ____
Type of Identification Produced _
Commission No.
• ExpiresAugasl
Revised 07/15/2019
w: room additions
,
her non-residential use
ult in your paying twice for
and posted on the jobsite
or an attorney before
The for oing instrument was acknowledged before me
this day of _ (1 Jby
(Name of person acknowledging
'a—k Vttc-�--
(Signature of Notary Public, State of Florida )
Personally Known OR Produced Identification _
Type of Identification roduced
mission No.
Notary Public State of Floritla
My Commission HF
Expires 08/05/2024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURfLE
MANGROVE
COUNTER
---
REVIEW
REVIEW
---
REVIEW
REVIEW
-
REVIEW
-----
REVIEW
DATE
-
COMPLETE
-----
INITIALS