HomeMy WebLinkAboutBuilding Permit Application OG/17/2015 15:37 7727811307 FLYNNS AC PAGE 01
ALL APPLIC BLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
,2900 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 CX C.
OED IMPRMIM
Address:
Legal Description:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
J.
01
J.
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. . ,
J io a wor to Orme un er is permit—c ec a appy:
MVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
❑Electric Plumbing OSprinklers Generator Roof
Total Sq.Ft of Construction:: ` S Ft.of First Floor:
Cost of Construction:$ �7' J Utilities: Sewer Septic Building Height:
„_. ..
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Name 050 V1064A a An Namft
Address: Comphtfw- 775
City:__„ k �Q .�i� State: Address:
Zip Code:3 L4 I S Fax: _ _ City: State:
Phone No. 7 ' ��'`� _ _ Zip Code: FaX: �2'_�______
E-Mail:
PhoneNo.
Fill in fee simple'rtle Holder on next page(if different E-Mail: rl✓1
from the Owner listed above) State or County License: S!� Y
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
06/17/2015 15:37 7727811307 FLYNNS AC PAGE 02
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DESIGNERANGINEER:. _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State: T
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 that is granting a permit will authorize thepermit 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,
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
commerlcmg work or recording our Notice of Commencement.
ignature o ner/Lessee/Agent bre of ' ractor/License Holder
STATE OF A FLORI STATE OF FLORID
R, 1 / -
COUNTY OF d 1J1G11 �(1 ----- COUNTY OF . If lr
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J_t�_day of 20 (L-by this day of 20 !�$ by
( ame of person ackno le ging) (N me of person ackno ) MCfELEJ.BROWN
WARY PUBLIC
STAVE OP FLORIDA
(Signature of Nota ate of Florida) (Signature of Notary Pu tem/1�D1e
Personally Kno n �ctification Personally Known OR Produced Identification
Type of Identificatio 0. Y Type of Identification Produced
Commission No. Commission No,6C1* (Seal)
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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
INITIALS