HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONii
All APPLICABLE INFO MrST 8 COMP LICATION TO BE ACCEPTED
Date: (i it Number:
Perm
SCANNED
. . . . . . BY
cie County
Building Permit Application
Planning and DevelopmefirServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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Legal Description: CX"60,— &�O,--6 WK
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Property Tax ID #: Ys�,o - _s-(o ir-000n 66, 73 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
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—Mechanical Gas Tank — Gas Piping Shutters —Windows/Doors
— Electric Plumbing —Sprinklers Generator L`_Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ (0. 00 Utilities: Sewer Septic Building Height:
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FEE SIMPLE TITLEHOLDER: _NotApplicable BONDING COMPANY: Applicable
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City: — City:
Zip: — Phone: Zip:, Phone:
6WNER/ 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 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
ornmencing work or recording your Notice of Commencement.
Signature wrier/ Lessee/Contractor KWJent for owner
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Signaturd' of Contractor/Ucense Holdgir ;o'
STATE OF FLORIDA
COUNTYOF
STATE OF FLORIDA
COUNTYOF
The f . instrumeyt was acknowledgedbefore me
this N—M of /t/0 1" Yzby
The f was acknowledged before me
thiswofAkv. 20a by
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(Name of person acknowledging)
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(Name of person acknowledging)
(Signa riofNota Public- State of Florida)
(Signa re of Notary Public- State of Florida)
11
Pers 2yKnown (/'�' OR Produced Identification
PersonallyKnown L"'� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Commission No. 14 &5 45';';�;,& Se JUSTIN DAVID CONE
Cry Public - State of Flor!
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C mission N VIDCONE
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Notaj,", IF State Florida
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Commission 0 GG 196519
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