HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA LE 1 FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-155.3 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from:'dropbox, click arrow at the end of line
Address:
i�,l Intl . S wee -Fu.0 C+ rc( e
Legal Description: RarboL r#ZL(A VIA (,14L
Property Tax ID#: 4414 -go3- 007-4— 000 7
Site Plan Name:
Project Name:
Setbacks Front [UC I Back: Right Side: Q0 Left Side: *
lh5-a1( 120 130-t -i' LAtf- �
(0' ,,2)(,+y- 0►- JIAe- %2
i Iona wor o e e ormed unaer tnis pernm — 061
❑_ HVAC Gas Tank [:]Gas Piping
❑Electric 0 Plumbing []Sprinklers
Total Sci: Ft of Construction:
Cost of Construction: $
-7®®. 00
Cooktrfa.
e (A In 1+ 1
Lot No.
Block No.
MUFFly,
_ Shutters Q Windows/Doors
Generator 1Roof Roof pitch,
S Ft. of First Floor:
Utilities t Sewer OSeptic Building Height:
Name pC *ir'" —pEa i ��`� • ...,:� ,
Address: no 50 Nw .
City: f� /? State:
Zip Code: 3 y9'1v Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:
Company:
Address:
JWyties i
(710%(-,C1k
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re;t I�1
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City:
Sht CL&
State: 1-
Zip Code:
9
Fax:
Phone No.
11 L-
18 I - 112-77
E-Mail:
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State or County
License:
U,5 15
If value.of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
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_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:.
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
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 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 reg6rding vour Notice of Commencement.
Signature of Ovyner/LesseeyContractor as Agent
STATE OF FL RIDA
COUNTY OF�—
The forgoing instrum nt was acknowledged before me
this �. day of 20by
(Name of person
Commission
Revised 07/15/2014
ng )
State of Florida )
-�11,M)ssion # FF 234130
MY Comm, Ezt(6ep4aY 27, 2019
Tided throe h
�,,,�, 9 National Notary Assn.
Signature
STATE OpFLORIDA
COUNTY F"_ujc� -e--
The forgoing instrulpent was acknowledged before me
this a day of 20 L'�L by
(Name of person acknowlgdging) A /
(Signature of Notar� Public- State of Florida
blic - State of F
Commission # rr z3vou
Comm. Expires May 9
idedided thromh National No, As n.
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