HomeMy WebLinkAboutBUILDING PERMIT APPLIACTIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPL%'J0#&CLBE ACCEPTED
Date: BY Permit Number:�U
St. Lucie Cni/n�
Building Permit Application
Planning and Development Services ✓G,t' d k3e
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 s
9 ,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial � Residential f
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at end of line �<
Address:
Legal Description:
Property Tax ID #: 14-/6?X —SCI l" CXI66L— (rnl) S Lot No.
Site Plan Name: —t— Block No.
Project Name:'i ) r
Setbacks Front Back: Right Side: Left Side:
d,Lu-x LLD_,__ ,
OHVAC IJ Gas Tank Gas Piping
11 Electric ❑ Plumbing Sprinklers
IITotal Sq. Ft of Construction:
Cost of Construction: $ r
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Shutters Q Windows/Doors
Generator E—] Roof
S Ft. of First Floor: _
Utilities: MSewer Septic
Building Height:
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CONTRACTOR :.� f, ... i R
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Name
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Zip Code: Fax: (V
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E-Mail:
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: i
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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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
BONDING COMPANY: Applicable
Name:
_Not
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anScovenants 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 1 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 our Notice of Commencement.—
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Sign ture of Owner/ Agent/ Lessee
Signature of Contractor License Holder
STATE OF FLORID/� 1 [
STATE OF FLORIDA
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COUNTY OF Y"C LO4 (—
COUNTY OF j I_CJ C,I4e
The for oing instrument was acknowledged before me
The fo ping instrument was acknowledged before me
this�dayof20 by
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(Name of person acknowledging )
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(Name of person acknowledging )
(Signatur of�ary Public -State of Florida)
(Si nature a Notary Public- State of Florida )
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Personally Known �—OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission
CommissionR" t7UE40
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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