HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 66
Date: 13�15 Permit Number: 5 0 y
RECEIVED JUN 03 201
Building'Permit Application -
Planning and Development Services
Suilding and Code Regulation Division
2300 Virginia Avenue,Fon;Pierce FL 34982 �I
Phone: (772)452-1553 Fax:(772)462-1578 commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line O�L
Address:
Legal Description:
Property Tax IQ#: Lot No.
Site Plan Name: Block No.
Project Name: I ea
Setbacks Front ack: Right Side: Left Side:
ton or to orme under s permit—c ec a appy:
HVAC^ Gas Tank ❑Gas Piping Shutters Q Windows/boors
Electric LJ Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction _ S ,Ft,of First Floor;
Cost of Construction:$ Utilities:�Sewer Septic Building Height:
Name Name.
Add re T Company:
City; fit' i ,/• State: L Address: r .
Zip Code: Fax: City: State:
Phone No. Zip code �2.- Fax: t•
E-Mail: Phone No. •L
Fill in fee simple Title Holder on next page(if different E-Mail. ` C.
from the Owner listed above) State or C my License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
E00/ZOO12 33IA83S*A»013V3*0aV80a8 L89LL9VZLZL XV3 EO:ZL 9LOZ/E0/90
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 County makes no representation thatisgranting a permit will authorize the permit holder to build the subject structure
which is In conflict with am applicable Home Owners Association rules,bylaws or and covenants that may o lb-ii such
r w c
structure.Please consult w th your Home Owners Association and review your deed for any restrictions h 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 roams 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
imp
ovemerits to your property. Notice of Commencer t be recorded and posted on the jobsite
first
_Jen must
be e the inspection. If you Intend to o I consult wit lender or an a orney before
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comEncin
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1110m of rson acknowle of per n ackn-o%Wledf1ngJ) J
ignatUre&I-Aotary Public-State of Florida) (Signature of otary Public-.State of Florida)
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Personally Known ��OR Produced Identification 'Personally Known__L ---OR Produced Identificatfon
Type of Identification Produced Type of Identification Produced
Commission NOA-:r-c?!z'� (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW RE,VIEW REVIEW REVIEW
COMPLETE
L INITIALS
800/800121 33IAd3S*Ad013V3*08VAo8e 189LLSVZLLL XVJ vo:ZL 9LOZ/80/80