HomeMy WebLinkAboutBuilding Permit Application ALL APPLPH!,K INFOMUSBk COMPLETED FOR APPLICATION TO HE ACCEPTED
Date �l Permit Number:
RE.CEIV7D OCT 0 7.2015 -
Building Permit Application -
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue,Fort Pierce FC 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line
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Address: e'l
Legal Descrlption: t 2 ' fly 0-V V* dRL OP ��r G�-
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Property Tax 1D#: Lot No.
Site Plan Name: Block No.
Project Name: ` -
setbacks Front Sack: - Right Side: Left Side:
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itio wor o e e ormed uncl&this perms —check'all That appy:
VAC Gas Tank [Gas Piping _Shutters D Windows/Doors
Electric F-1 Plumbing Sprinklers 11 Generator Roof
'72Total Sq.Ft of Construct(lorl. 1 � S ,Ft.of F(tst Floor:
Cost of Construction:$_`- t t _ � �_-� Utilities: Sewer Septic Building Height:
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City: State: Addres -
Zip Cade: ax; City: _ _State
Phone No. ( ' zip Code: Fax: r
E-mail: Phone
FilI in fee simple Title Holder on next page,(if different E-Mail: ,'
from the Owner listed above) State or C linty License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
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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 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 respecfs,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
imp ovements to your property.A Noti -ef m nce en must be recorded and posted on the Job ,,,,,,,,,,,
bef a the first inspection, if you 'nten ta,at' fi anti consult wit lender or an attorney before ;{tip ' r
tom encin w din r N "` ' " enc gent.
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!��STATF O 3 STA E OF+COUO p x COUOF 1 �,
The f r oing in e qt M129 ,
acknowledged f4e�n ' The rgoIng instrume t w s acknowied ed before me a
this day af�" � � 20 rt r this day of �20jby
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ame of p r n acknowledgin ) (Name o on acknowledging
ignature oylotary Public-State of Florida) gnature of ary Public-State of Florida)
Personally Known _✓ OR Produced identification Personally Known_ t Produced Identification
Type of Identification Produced Type of identification Produced
commission No, t --rte (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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