HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEINFO ST BEICOOWLETED FOR APPLICATION TO BE ACCEPTED
Date: ~c Permit Number:
Building Perry' t.Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce:FL 34982
Phone:(772)462-3553 Fax:.(772)'462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: D 7-410 c5. DCC J) t VF
Legal Description:
PropertyT.ax.ID..#: 5 " t. " (7)Z::!5n Lot No. .
Site Plan Name: Blockft.
Project Name:
Setbacks Front Sack: Right Side: Left Side:
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HVAC Gas Tank Gas Piping _Shutters Windows/Doors
LElectric Plumbing OSprinklers F]Generator _Roof
Total Sq.Ft of Construction: S�of First Floor:
Cost of Construction:$ a. '� t �r U Utilities- Sewer n5eptic_ Building Height:
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Name�CJ'�Li l� I b Name LWA
l#dclress:�(}t�r ' ��?rtil l'l , gG IUB '
Company. 0 f�rT` t¢L (?tJitLS(i
City:, F(CL
State: ' Address: SPL
Zip Code:., Fax: lrl—t � ) 7 3�J� City: J r�1S -66" State:
Phone No. D7 ( Zip CFax: '77'`,535'Qt
Phone No. �'ZZ— OTZ-06 t
E-Mail: .-
Fill:in-fee.sirnple Title Holder on next page(if different E-Mail: 7z�� 1��� �
from the Owner.listed above) State or County 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:
Phone: Zip: Phone:
FEESIMPLE 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 isgranting 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#hat may restrict 6r 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 wlll,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 afid.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.
signature-6f Owner/Lessee/Agent Signa re o tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �-Aii;i—i t-�) COUNTY OF "(41i,T113
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
d iU.day of, . 20 15by this day of _(Q20 by
(Name of person acknowledging). (Name of person acknoWledging
(Sig ature of Notary Public-State of Florida) (Sig um o#ary Pub/li�c-State of Florida)
Personally Known Y"_ OR Produced Identification Personally'Known V OR Produced Identification
Type ofldentification Produced Type of Identification Prod
�+ ^- Co i ion N FF 907740
Commission;No. (Seal) Commission No. •= I
° M fission Expires
Janurary 14, 2017
JOY D�ADA.MS.- .�•,�,�",•�
3,... commission
Revised 07/15/2014 My Commission Expires
fit January 1.4, 2017
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA.TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
1NI1'IALS