HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INPO MUST BE ?LETED FOR APPLICATION TO BE ACCEF . _�
Date: ® Permit Number:
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 'Fax: (772) 462-1578 Commercial Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 6 55& 5-0 as
Legal Description:
PropertyTaxlD#: -000c/-000--1 Lot No.
Site Plan Name: Block No.
Project Name: don-/Cl5?i (/LGLrCyL 0
Setbacks Front Back: Right Side:
f•tDETiALRP44
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�/1an92� o_� DCCu�aOte�
HVAC L J Gas Tank UGas Piping
Electric Q Plumbing []Sprinklers
Left Side:
n.L Graur }J 3 7o 46sem h/
sin-1t • _10�.. NO
a app y:
_Shutters Windows/Doors
Generator 01 Roof
Total Sq. Ft of Construction: / SS.S S•f• 5 Ft. of First Floor: _
Cost of Construction: $ Utilities Sewer I Septic
Address: /oS-66 So /, s /�-WV
City: Pwi- c5_4, State:FL
Zip Code:3LH-5 2--- Fax:
Phone No,g7a-3S&-J.X
E-Mail: Ina-"I-e ./''0
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of construction is $2S00 or more, a RECORDED Notice of
Name: ,
Building Height:
Company: )Y/£L2GFr��` t+07" -LiNE
Address:ZL(v_Z IJN GeSGZ!/C PiaPK 'T,z
City:';�be.lS,�,(.GGrq�%r State '?,
Zip Code: _ 3V gB!e Fax: 772—,i73-*L*b(�
Phone No. 777_—P573-67o17 /oy
State or County License: Ca2C2 D6 23W
Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
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 c nsult with lender or an attorney before
commencing work or recording vour Notice of Commence a t-. . - .,
STATE OF FLORIDA ` STATE OF FLORIDA
COUNTYOF Sr-- V� t� COUNTYOF 5t • LUciTZ
The forgoing instrument was acknowledged before me
this 7 day of Cam\ O 0-'T e . 20 /Sy
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known • OR Produced Identification
Type of Identification Produced
The forgoing instrument was acknowledged before me
this dayof- QC\\6aSQ .20 /Sby
(Name of person acknowledging)
(Signature of Notary Public -State of Florida )
Per,SsnaLy It^ow"' OR Produced Identification
Type of Identification Produced
Commission No. n. (j . Pablle state; Florlda l 1iommission No.
. Brian S Roat I {
Revised 07/15/2014
Brian S Roat
of Florida
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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COMPLETE
INITIALS
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