HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
Date- 14- Vb Permit Number:
RECEIVE/
D
Building PermitApplication
MAY 1• I
15
Planning r r Development
Building and Code Regulation Division
II VIrginid Avenue,Fort Pierce FL
Phone: +6 I+ . Commercial Residential
PERMIT APPLICATION
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Legal Description.
Site Plan Name:. Block No.
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is pe rmit—check afftint apply:
■I DHVAC Gas Tank
DGas Piping 1• M••
UElectric 0 Plumbing E]Sprinklers Generator Roof
Total Sq.R of Construction: IS, Ft of First Floor:
Septic Building Height-
Cost of Construction. cA4W.60 Utilities, Sewer
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DESIGNER/ENGINEER: _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 CountyY makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is In conflict with an 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
commencing work or recording our Notice of Commencement.
`Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STA'T'E OF FLO I A STATE OF FLORID.Q�f�
COUNTY OF COUNTY OF�,
The for in instr ent was acknowled a efore me The r g fnstr nt was acknowledg d efore me
this ay of ,-, , 20 6:Zb� this day of ZO by
'nn . . 1 i,ls1�►� r Imo- U1(%l�
(tame of person acknowledging) (Name of person acknowledging)
QL� QUK.&A2� 0U"_ D, V
ibb
(Signature Yf Notary Public-state of Florida} (Signature o otary Public-State of Florida)
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Personally Kn w. ... . . • r Personally K: O Produced Identification
Type of Idenfl , rg uce Type of Iden ica4p�P,�o uce
•s Y P a,� �rya^�` 'f. CRYSTAL QUEVE00
Commission N ► .1 Notary Pribll� t��gi.FlGrlda: Commission 6»Q' +� • Notary,Public-519ea1}Florida
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ues juh�1,'2015. _ = y omm..l:xplres.Jm 31.•2015;
F r' Commission 0 EE i 17478OommlS'slan EE t•7A7
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIAL5
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