HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE NFO MUSt'BE C.P PLEEED'FOR i4PPUCATlt'AN TO BE ACCEPTED
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Building PermmK Application
Plan iingandDevelopmentServices
Building and[ode Regulation:Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:;(772)462-157$' Carnmerclal Residential
PERMIT APPLICATION FOR:. To Select fromdropbox;click arrow:at the end of line
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Address:
Legal Description:
Property Tax ID#: .. Lot No.,
Site Plan'Name: Block No.;—
Project Name:
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Total Sq.Ft of Construction: _ S .Ft.of First Floor:
Cost of Construction:$. ) Utilities.
:Sewer05eptic Building Height.
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..,Pidd�ress:�.��'!�i CLI'( (l��l�'.D � ��C 1t�b Company:
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City:
State::; Address: b• fin.
Zip Code:. (q Fax: 4 city: ,, Owl State:l�J.
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Phone No, �-�b�� �I SZi,
E Mail:
Phone No. '772' 92
Fill'in fee simple rile Holder on eaext page,(iff`different E-Mail: C h" r�
fCmrtt'4lte Ouwner listed aboire State or"County,License:
tF-value of construction is$2500.or more,a RECORDED:Notice of Commencement is required:
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®ESIGRiERjE119GiRiEERc w Not;Applicable. MORTGAGE COMPANY; Not;Appiicabie
Name:. Name:
Address: Address:
City State: City: Statei
Zip: Phone: Zip:_ Phone:
SEE sINdOPL.i:Ti'Tl.l:HOLDER:; Not Applicable BONDING+COMPANY:. _Not Applicable
Name: Name:
Address: Address:
City; City:
Zip:, Phone: Zip,: Phone-
[cer0fythat no work or.installation has commenced prior to theassuance of a permit:
St.Lucie Counttyy makes norepresentation:that is granting a permit wiil:authorize the permit holder to build the subject structure
which is in conflict'with any applicable Horne Owners Association rules,bylaws or ancovenants that mayrestrict or prohibit such
structure.Please consult withyour Honre.:Owners Association and review:your deed.for anyrL-Ari.tions which my:a
appiy.
In consideration of the:grantins of this reguested.permit,:I do herdby agree that l will,in all respects,perfoim the work
in accordance with the approved pians,the.:Florida.Building Codes and St.:LucIe County Amendments:.
the following building permit applications are exempt'from undergoing a`full concurrency review:room additionsi
accessory structures,swimming poolsfences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure>to Record a Notice of Common emerit may result:3n 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
,commencingwork orirecordin .N
ourotee of Commencernent.
s
Si of Owner/Lessee/Agent Sign pis contractor/License Hoiden
STATE OF FLORIDA STATE OF FLORIDA 1
,COU.NTY OF M61?-.T11J 000NiTY OF
The forgoing instrument was acknowledged before me: The forgoing instrument was acknowledged before me
20.iul _Iiy this day of: 6C-TP8 Z_- ,20 l�by
(filame of person-''acknowiedging.) (Name of:person acknowledging)
a -I� r
(Si natures Notary Public State of.Florida} (Sig azure �lotary Public-State of Florida)'
Personatly`Known. OR Producedadentificatron
Personally Known,. OR produced Identification
Type of Identification Type=ofidentificat on'Prod uced
i
b�`*r , JOY D ADAMS ;4. ,k.. -. ��.�xQ ��A
Commi 8 it FF 907240 Commission No. °� e` COmm1s35�tJ D
Commission No. _. • .. :^ i A o7ao
My Commission Ex ires
P My Commission:Expires
January 1.4; 201 7 '%o an°; � Jonua l d 2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION: SEA TURTLE MANGROVE
COUNTER REVIEW REVIEWREVIEW REVIEW REVIEW REVIEW
DATE'
COMPLETE:
1NiTIAIS