HomeMy WebLinkAboutBuilding Permit Applicationr-
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED �]
Date: ` �� Permit Number: o �� �aG �I
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RECEIVED JUN 12 2017
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 ��R 4 _,Ma A ,% j
Address: 43--10 Pc�D-%-6 f2. -26j� R, 34q `
Legal Description: . _PLI p) CDT' G cc), so la(:
Property Tax ID #: 04 30 - SO - OCR - H Lot N
Site Plan Name: Block No.
Project Name: _W1�S K)e_
Setbacks Front Back: Right Side: Left Side:
Aaaitional work to oe ertormea under this permit -check all apply:
EIHVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers F]Generator 29Roof Roof pitch
Total Sq. Ft of Construction: - 1 1 5 0 S . Ft. of First Floor:
Cost of Construction: $ . _ Utilities:_ Sewer [] Septic Building Height:
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Name I^(lC3
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Company:
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Zip Code: Q ,c60 Fax:]PQ -(P 3
city:
Stater
Phone No,_4_�_a - 13it�'" 0
Zip Code: Z --4'
Fax: -$033
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Phone No: •-.-6D3-
Fill in fee simple Title Holder on next page ( if different
E-Mail.
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State or County License:OX-c_
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from the Owner listed above)
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
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 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 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 additions,
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
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenciniz work wording vour NotiGe-Vf Commencement.
er/Lessee/.E6ctor as Agent for Owner
STATE OF FLORA o
COUNTY OF l,l,t�.t�
The forgoing instrument was acknowledged before me
o
this 7t►'` day ofCNAA!�� 2013by
(Name of
STATE OFF 'J COUNTY OF
The forgoing instrument was acknowledged before me
this.L day of�k- 20 t'4 by
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(Name of pers
Notary Public- State oTF)fricla) I (Signaturl o! Not�4Public- State of FI'o
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Revised 07/15/2014
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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REVIEW
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DATE
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COMPLETE
INITIALS