HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICA LE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� SCA-p,19i11Number:
_ BY
St. Lucie County fi4unoo sion-1 -IS
Building Permit Application a3NG
Planning and Development Services
NVOS
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: I I U 1 1 1 >I r e!
Legal Description: r! _')s &40 1� metro Ar oP i
11W N Lese. i S /110L Pram 1.��3s
Property Tax ID #: aL /' ! 'o_P4— nm 1y— cOc
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
HVAC L_I Gas Tank UGas Piping
Electric 11 Plumbing OSprinklers
Lot No.
Block No.
Left Side:
-rrv•
Shutters []Windows/Doors
Generator 'O Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ (Q� ( Utilities. sewer 0 Septic Building Height:
x.�3.0 w.5 +.T • Y� .. c. k.
:`! .R �y`°.. _ �a A. .�.E..3. 44.*XL.f.?J.. `3
Name ^1 \
Name:
Address:
Ace
Company:
City: GYz�-cluchState: kL- ,
Zip Code• Fax:
Phone No.)n
Addr s:
city:
Zip Code:
Phone No. �—
State:
Fax
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: rKkP&QktWl
State or County License:
C
If value of construction is $2500 or more, a RECORDED Notice or commencement is reguirea.
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
St. Lucie Countyty 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
your N commencing work or recording otice of Commencement.
STATE OF FLORIDA
COUNTY OF
The rgoing instru lent as acl owledged fore me
thi�day of.QA, 20 �by
c_�C\ct,,Y4 W l (\C
;Name of person acknowledging)
Personally
Type of Id(
Commission
Revised 07/15/2014
State
My Comm. Exgras ay Z7 .2919
STATE OF FLORID
COUNTY OF -Loj rle,
The forgoing instru;;��gqnt��was ac�knowledge before me
this �day of t-1 � 20by
A ;rInr� edlk b ► I
( ame of person acknowledging )
v /
Personally Known V OR Produced Identification
Type of Identification Produced
Commission
BROWN
My Comm. Expires M;
-Commission Y'EE
"•ui;n•" Ban
IDroup one
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
L
A GROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS