HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
/� • SCABNNED Permit Number:
,—, St. Lucie County
Building Permit Application MAY, RECENVED
Planning and Development Services PI(il 18 2016
Building and Code Regulation Division ,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address: C-)%\\
Legal Description:
Property Tax ID #: �L% �1�'
1�(1 ��
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Lot No.
Site Plan Name:
Block No.
Project Name:
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Setbacks Front
Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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Gas Tank
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Piping
apply:
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_Shutters
Windows/Doors
if ectric FPlumbing
[]Sprinklers
1:1Generator
Roof
Total Sq. Ft of Construction
5 S
Ft. of First Floor:
Cost Construction: $ 1J, OLJLI
of
Utilities..
Sewer-li{leptic
Building Height:
OWNERAESSEEs "CONTRACTOR:
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Name n 2,1 Y_NJ
Name:
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Address: %1
Company: G
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City: Stater
Zip Code: Fax:
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Phone No.
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E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: r�_'�r• otZ�zS
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State or County License:
it value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION`Llt LAW, INFORMATION:•,
DESIGNER/ENGINEER: --�
Name: Cp_t&C'
Not A Applicable
Pp
MORTGAGE COMPANY:
Name: 1) Ul
Not Applicable
Addres
4
Address:
_
City:
Zip:
Phone:
State J_
City:
Zip: Phone:
State:
FEE SIMP
Name:
/�TLE HOLDER: _
�N i m �.
Not Applicable
BONDING COMP
Name: �1
_Not Applicable
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 recording vour Notice of Commencement.
_ ure of Own / Less /Agent
ure of Contrac r/Licen a Holder:
••••.y;
STATE OF FLORIDA —
TATE OF FLORIDA
COUNTY OF
'ate
` OUNTY OF
The fo going instrument was acknowledged efore me
day by
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he forgoing instrument was acknowledge Ljefore
his/0 day � by
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this of 20
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(Name of pers n acknowledging)
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Name of person acknowledging)
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(Signature of No Public- tate of Flori )
(Signature of Nota b� State of Florida )
r/
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
Commission No. (Seal)
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS