HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �t1�j 1 �� Permit Number:. 31()6_ (3 30a
RECLIVED JUN 14 'M17
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Legal Description: / re S k, •
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Property Tax ID #: Lot No. Iva
Site Plan Name: Block No. 2 CIS
Project Name:
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Additional work to e nertormed un ert is permit- c ec a flapply:
E1HVAC Gas Tank ❑Gas Piping _Shutters Wi dows/Doors
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Electric 0 Plumbing Sprinklers Generator Roof J f' Roof pitch
Total Sq. Ft of Construction: * /Pa S . Ft. of First Floor:
Cost of Construction: $ '�_ 3 I0. 60 utilities:Sewer Septic Building Height:
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Name
Name: S. (}
Address: tow _
Company:
Address:
City: State: E,
Zip Code: Fax:
City: 61b& State
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Zip Code: R' q Fax: �� _q�
E-Mail:
Phone No. S-_ S
Fill in fee simple Title Holder on next page ( if different
E-Mail: Do pis
from the Owner listed above)
State or County License: Ce?03�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
7
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
commencing work or recording vour Notice of Commencement--?
Signa caner/Lessee/Contractor as Agent for Owner Signature of Contractor/Lice
STATE OF FLORIDA STATE OF FLORID
COUNTY OFF Lm(,ut, COUNTY OF iiL
The fo pp,,��11�� instrum t was cknowledged fore me The for oing instrument was acknowledged before me
this:JAay of 20 y this day of �, (iLl'Lf _ , 20 Ja by
(Name of pe(s n acknowledging) (Name of -person acknowled g )
, lm� I i�� Np�yy - 4n,4a I hz
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identif ation00' Personally Known OR Produced Identification
Type of Identification ProducecL'f��1&P5 r7?,Q&o,0—ADType of Identification Produced
Commission No. M "1 Commission No. (Seal)
eaP Notary Public State of Florida
Jennifer Davis ° Notary Public State of Floric
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Revised 07/15/2014 Expires 02/29/2020 OF IV Expires oy29/2 20 9�029
REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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DATE
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INITIALS