HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date;
. Permit Number:
� II■�I��III,�I■III■ II
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:
Legal Descriptlon:
Property Tax ID#; Lot No.
Site Plan Name: Block No.
Project Name: 1
Setbacks Front ack: Right Side: Left Side:
Ot 72--15 -�On V'S
AddiVoW work to Orme under is perms —c ec a appy:
VAG Gas Tank QGas Piping CGenerator
Shutters Windows/Doors
Electric 0 Plumb�inig Sprinklers Q Roof
Total Sq.Ft of Construction: .Ft.of First Floor:
Cost of Construction:$ Utilities Sewer Septic Building Height:
Name Nam
Address: Company:
City_ _ State:_ Address: t
Zlp Code: Fax: City: State:
Phone No. - Zlp Cade Fax:
E-Mail; Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: `
from the Owner listed above) State or dunty License;
I f value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
E00/L00 ) 33IAa3S*AH013V3*Q8VA089 L69LLSVZILL XV3 9z:VL 9LOZ/90/90
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DE5IGNERANGINEER: Not Applicable 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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County make noYrepresentation that is granting a permit will authorizes the permit holder to build the subject structure
ssttructure.Pleas cconlsult wlthpyour Home Owowners
ers Ass ciation and review your deed for any restrithat
t onmay
which maor
alprohibit such
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 pians,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
P ovements to your property,A Notice of Commence ent must be recorded and posted on the jobSite
bef a the first inspection. If you 'ntend to obtain finance ,consult wit lender or an attorney before
cam encin w den r Notice of Commenc ent.
Signat a of SLL see Sig tore o Co ra ice se Hold
STA E 0 ORMA
STAT' °o cau oF_ ., .�'
" ` The forgoing Instru n as acknowledged be •I"°%`-
The forgoing Inst e w acknowledg g ^!� `t g
this�day of�t 20 �"; this day of 1 .21)_1b
lot
(NameDf per on cknowledging) e, g {Name of perso acknowledging) Ji
e y y y r
r
a
Signatur Notary Public-State of Florida} ignature of otary Fubiic-State of Florida} T c y
G O CA [Rai
Personally Known '-�-"jpR Produced Iden cid,° "' Personally Known \"'�OFt Produced Identifi
Type of identification Produced N a Type of Identification Produced��
Commission No. z. ...s_�„ {Seal} w commission No.rer- (Seel)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
E00/ZOO33IA83S*A8013V3*08VA089 L68LLSVZLLL Xd3 9Z:Vt 9LOZ/90/90