HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MU% BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: (P SCANNED PermitHumber:�2��
BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1576 Commercial t� Residential
[ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address:
Legal Description:
Property Tax ID #:
�NM� Ar.�
Lot No.
Site Plan Name: r Block No.
Project Name: A44 V6' e_
_Setbacks Front Back: Right Side: Left Side:
CON.STWg.,,k NAIVE-
AUanional work to l3e nerrormea un er ispermrt-c OCK all a apply:
0HVAC Gas Tank ❑Gas Piping _Shutters aWindows/Doors
ElElectric 0 Plumbing Sprinklers E] Generator L(_d'koof
Total Sq. Ft of Construction: SC)
Cost of Construction: $ l r 000 •yb
S . Ft of First Floor:
UtilitiesSewer[]Septic Building Height fs
OWNER/LESSEE' `>
CONTIACTOR s a
Name QS
Name- S
Address:
Company: o P
City:"Sfl
State:
Address- C5 Q�5
Zip Code: a W V7 Fax:
City: State:
Q
Phone No. :17�'� ��� �-T[30
Zip Code ��c%%S Fax
E-Mail:
Phone No.
E-Mail:. O
Fill in fee simple Title Holder on next page( if different
State or County License:
from the Owner listed, above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
City:
Zip:.
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: I Not Applicable BONDING COMPANY: _Not Applicable
Name: Name.,
Address: Address:
City: City:
Zip: Phone: I Zip: Phone:
I certify that no work or installation lr s commenced prior to the issuance of a permit
St. Lucie County makes norepresentaiionthat isgranting apermit will authorize the permitholder tobuild the subject structure
which is in mntlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Hdme 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
_ Signaturdof Owner/
STATE Of FL
COUNTY OFORIDA y((/./ „j 1� I COUNTY OFORIDA ifA.r —Ml
The for o}l'�[instrument was acknowledged before me The forgoing instrument was acknowledged before me
this r day of S�-j(,d7� 20 aby 20 LJ by
SA4o)G� _ :.f'We
(Name of pe acknowledging) (Name Tpeacknowledge )
(Signature cirN&erj Public- Florida) (Signature o P -S fe of Florida )
Personally Known E/ roduced Identification Personally Known OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission
Revised
KIERAN WANE FRAMPTON
EXPIRES May 23. 2021
Commission No.
FRAMPTON
EXPIRES May 23. 2021
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
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INITIALS