HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date; Permit Num .ber:,/50 l �r
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) 452-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Property Tax ID #: � - • � - ai 1 �,' �`—� Lot No. 12
Site Plan Name: Block No.
Project Name:-,, -
Setbacks Front Back: Right Side: Left Side:
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Electric ID Plumbing Fl
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Total Sq. Ft of construction:
Cost of Construction: $ ~ (,
klers L_i Generator
Windows/Doors
t..1 Roof
SCI. Ft. of First Floor:
Utilities:MSewer Q Septic Building Height:
Fill In fee simple Title Halder on next page ( if different
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of
Name: ZY
Company:
Address.
City: State:
ZIP Code; Fax:
Phone No, 31
E -Mail:
State or County license:
is required. jJ '
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Name:
Address: -
City, state:
Zip: Phone:
FEE SIMPLE TITLEHOLDER; ,_ Not Applicable
Name-,
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip; Phone:
BONDING COMPANY: _ Not Applicable
Name:
Address-
City:
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 5t. 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 Commencelent must be recorded and posted on the jobsite
bef*e the first inspection. if you `intend to obtain financi , consult wit lender Oran attorney before
rnmlinancina w�.wrecardine vdbr Notice of Comment ent. "�� I t _
STA
The fol Inst ent wasp cknowledgeed�bore me
khts day of , � y
ng
Personally Known _,�./ rQR Produced Identification
Type of Identification Produced •• . M- ...,_�. -__
STATE OE40RIDA % I .n \
The forgoing instrpcnent was acknowledged before me
this day of zo. gby
(Name of per n acknowledging j
____7
of rr tory public- State of Florida )
Personally Known ✓OR Produced Identification
Type of Identification Produces — = - - -
r ALYNNF RUSSELLJO7
mmission Na. J @ I,YrgiNE RUSSELL
Commission No.-� ' + ' ;�'':,oPublle - slate of Fl , • Notar - State of Florida
:a, +
My Comm. Expires Jul 22, •, t '�. My Comm. ExPlra9 Jul 22, 2011
r•+rrta ` 'Nrrat'
FP 038
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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