HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: In Permit Number.
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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 Commercial Residential _
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: C&EFac F I I r
Legal Description:
Property Tax ID#: �Z'7 �W � �� Lot No.
Site Plan Name: Block No.
Project Name: ,[(
Setbacks Front Back: Right Side: Left Side:
e 40L PYM1�4 3u-I LIND -a 3�
Additional work to be performedun er t is permit--cheCK all appy:
1]HV L_J Gas Tank E]Gas Piping CGenerator
ShuttersWindows/Doors
Electric 171Plumbing U Sprinklers r Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ �_ Utilities:[Sewer Elseptic Building Height:
Name Name:
Address: ) �JU'
pang: 1
City: lj ti' State- ��' Address
Zip Code:3Fax: City: State:LFI
Phone No. J- 9?9 A (74 C� Zip Code: �� Fax: �Q��C;P
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: r
from the Owner listed above) State or County License: FCI aZ_:�p 11�1=1
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
b00/zoo& XV3 30:80 3I0Z/90/90
DESIGNER/ENGINEER: Nat Applicable MORTGAGE COMPANY: Not Applicable
1
Name
Name: Name:
Address: 7Address:
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:
I certify that no work or Installation has commenced prior to the issuance of a permit.
St.Lucie Coun 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,
accessary 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 Inyour 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 I attorney before
commencinp[wert'or or our Naice of Commencement.
with 21attorne'y=belore
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Signature of Owner/Les`?b�ent Signature of Contractor) rise Hot
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STATE OF F STATE OF FLORI
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The fgrgoing instr dgeo,4efore me The f ing Insedged before me
this_.W day as acknowle20 Jw1by this for e t was acknowledged
day of 20a by
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(Name 0 son acknowledging) (Name of per o aciinbwledging)
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( ' ata Public-_State"&N4orids) (Sign lie-State of F ori a}
Personally Know111101d n n Personally Known OR Produced identification
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Type of Identifi A Type of Identification Pr STEPHANIE
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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too/60018 XV3 ZO:80 9LOZ/80/90