HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE
Date: / 0 -o'.
FOR APPLICATION TO BE ACCEPTED �
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR
Address:
Legal Description:
Property Tax ID #:
Site Plan Name: A
Project Name:
Permit Nu nk
SGANNED
BY
St. Lucie County OCT 0 2 2018
Building Permit App iFA"Ring Depar . tMent
P
St. Lucie County, FIL
Commercial Residential
Setbacks Front Back: _ Right Side: Left Side:
—Mechani6l GasTank Gas,Piping Shutters
m ing '6enerator
—'Electri Plu'e Sprinklers
1P
Total Sq. Ft of Construction: Sq. Fi'6f l4irst Floor:
Cost of Construction: $ jjR�� 40?,Z(Z.0-�Utilities: _Sewer _Septic
Lot No.
Block No.
—Windows/Doors
Roof Pitch
Building Height:
WWNE LIE -SSE,
Name P./
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Addre OkA AIIL'l
Comp an�:
City: ateX-
St L,/
Zip Code: 191 1?1 Fa
Phone No.
Addres
s
City:,
0
Zip Code:
Phone No
Fax:
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail
State or County License
-J
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNWEN
Name:
INE I:
.19211
NotApplicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: ��Phone_/�_
A
'66
5tate:
01
— ��
City: State:
Zip: Phone:
.FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: —Not Applicable
Name:
Address:
Address:
City:
City:
Zip: -
Phone:
Zip: _ Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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 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 Corminencement 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
commencipw work or recordina vour Notice of Commencerrierris.
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STATE F�F RID
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The ;grgoing instrument was acknowledggQefor r"_8 it
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The f ing instrument was ackno le ged e
thi%,_e day of 201 by 8 m;
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thisTday of
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(Name of pefson acknowledgiA g!
IN on acknowledgin
aiiie of per5(
aw4,ea
(Signature of Not ublic- State offloricla)
(Signature oi Nota ubli.c- State of Florida
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION-
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIE
DATE
RECEIVED
DATE
COMPLETED
Rev.7/ZU1.4