HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE C01,,�] ,��TED FOR APPLICATION TO BE ACCEPT.'.
SCANNED Permit Number:
Date:
BY
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St. Lucie County
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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)462-1578
Cornmercial--y— Residential
PERMIT APPLICATION FOR:
Address:
Legal Description:
Property Tax ID #, 4s-o a
C) 0 00 - 00 0 - Lot No.
Site Plan Name:
Block No.
Project Name: G24Nle
Setbacks Front Back: _
Right Side: Left Side:
7
e
AdditionalworKTO be performed uncier this permit- check all that app y:
—Mechanical —Gas Tank
Gas Piping Shutters Windows/Doors
Electric Plumbing
Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of F irst Floor:
Cost of Construction:$ ZZ000, Utilities: _Sewer _Septic Building Height:
Name
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F-2 f2- pany:
.,Add.r
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-state: jE� Address: f
Zip Code:. 34 fS Fax:
City:
Phone No,
Zip Code: LYI/ 99 Fax. Z49
E-Mail:
Phone No 7-7Z '- ��W- 1
Fill injee si�;i;., I eron' if different E-Mail
TI I-i.Ao�.'A'-', pa ge
from the Ownerlis*-
1. 911 .1
Stat.e or County Lite ris
if value-6f 6o6iiruEti-66-ii'2�oo-iWrrioie,.a�itECORDED Notice of Commencement Is required.
— Not Applicable I MORTGAGE COMPANY: — Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: —Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTORAFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv 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 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, scr6en 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 in1pection. If you intend to obtain financing, consult with lender or an attorney before
commencing wdWror recording vour Notice of Commencenieftt.�
Wha owner/ Lessee/contractor as Agent for Owner
--Sigffffure of Contractor/Llcense Holder
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STATE OF FLORIDA.,
STATE OF FLORIDA
OF
COUNTY0_
COUNTY
Thefiorgoinginstrpentwa acknowledge efore me
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(Nam of erso acknowledging)
41eeadging
ignatbre7of Notary Public- State oTFlorida
gnature of Ndtary Public- Sfatiof Florida
Personally Known OR Produced Identification
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Personally Known _? OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
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COMPLET94 1:
'JW F 962709
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Rev. 7/2014 L-�_ "__
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