HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 ���•C�d�7
•
Building Permit Application JUL t5 1015
Planning and Development Services PERMITTING
Building and Code Regulation Division 5t.Luci
2300 Virginia Avenue,Fort Pierce FL 34982 unty,FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATIONS
Address:
Legal Description:
Property Tax ID#: J"u1�7 — b�� —��.�— Lot No. �"T2
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED{DESCRfIPTION OF WORK =
_ f
k +0 M(a"Y\\(DrCW&Y P�"
CONSTRU:CTIO,NINFORMATION �
Additionalwork toe nertormed under this permit—check a appy:
L�HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
0
Electric El Plumbing L�Sprinklers 11 Generator E] Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
r Ln�
Cost of Construction:$�� Utilities: Sewer _Septic Building Height:
OxWN'ER LESSE=E=}' " TRACTOR: ,
Name Name:
Address: r I Company: C_
City: State:_ Address- l.�
Zip Code: Fax: City: Stater
Phone No. 2- l7 Zip Code:5qqS,Z 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 County License-
If
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S"l`�JPPLEIVLENTAL*CONSTRU,CTIQN,LIEN:;'LAW,.INFORMATION:
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 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,
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.
s
=na � f Owner/Lessee/Agent Sign t e of Contra or/License older
SLORIDA �� STATE OF FLORIDA fA
COUNTY OF S��C' Q COUNTY OF LlQ CjJ_
The May
g instru ent%was acknowledged before me The fff,o�rr in� g instrum nt as acknowledged before me
this of 20�by this. ay of k 20�a by
)M�aca 6-
(Name of person acknowledging) (Name of person acknowledging)
v� uz V
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known t` OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced -ITuDeof Identification Produced
BRENDA-MARTINEZ n,,, BRENDA-MARTINEZ
Commission No. � ealkary Public-State of F o ission No. �°'y S nuary p,��.gds Fla
= Commission s I t 2a i '. I. Commission I FF 2314
Comm.Expires May 31,2u i 9
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F."�•• Bonded through National Notary Assn.
�,�����` ��''��'�� ``�� BorKM throw National Notary A n.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS