HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi -
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l 1` � n • l Permit Number: r � I
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Building Permit Application 5 201�Planning a i d Development ServicesBuilding and Code Regulation Division .Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7)2) 462-1553 Fax: (772) 462-1578' Commercial ResidentiO X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal De
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Site Plan N
Project Na
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Haa1t1vnd1 worK to oe errormea unaer tnis permit- cnecK all apply:
11HVAC, _ Gas Tank []Gas Piping _ Shutters
11 Electric 0 Plumbing Sprinklers E Generator
Total Sq. Ft if Construction: S . Ft. of First Floor:
Cost of Construction: $ —(<0 Utilities:Sewer [] Septic
_ Named
Address:
City:
Zip Coder
Phone No.
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Fill in fee s
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No.
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Roof
Building Height:
Gecl.# f Name:
Company:
A ,� State Address: / " �"
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Zip Code: `/// Fax: -4;&/-
Phone No. 5-&1- 2193- 602�
e Title Holder on next page ( if different E-Mail: &
r listed above). State or County License: �%02 %le
uction is $2500 or more, a RECORDED Notice of Commencement is required
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DESIGNF,.R ENG NEER: .
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FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip:
Phone: _
Not Applicable
State:
Not Applicable
MORTGAGE COMPNY:
_ Not Applicable
Name:
Address:
City:
State:
Zip:
Phone:
BONDING COMPANY- Not Applicable
Name:
Address:
City:
Zip:
Phone:
I certify that o work or installation has commenced prior to the issuance of a permit.
St. Lucie Courllty 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 your Notice of Commencement.
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_ Signature of Owner/ Lessee/Agent Signatur of Contractor/Licer
STATE OF FLORIDA STATE OF FLORID ,1
COUNTY OF /j(j�2 COUNTY OF
The f g ing iinstru s a knowledged fore me The forgoing instrument was
this ayl of 20 %by this __L dayyf
(Name of person acknowledging)
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(Signature of Notary V
ic- State 9FIorida )
Personally Known OR Produced Identification
Type of Identification Produ
$ ate• ota y u i ttate o on
Commission No.
F n s Donza
mission GG 092440
• OIN 10 Expires 07/27/2021
Revised 0 1/15/2014
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