HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
YPermit Number:
Building Permit Application
Planning • r Development
Building• . Code Regulation Division
11 Virginia Avenue,Fort Pierce
Phone:
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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ProjectLegal Description.- 14::��A-e
Lot No,
Site Plan Name: Block No.
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'Sewer Oseptic Building Height,
Cost of Construction:$ ■
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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 l 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-resldential 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 Commence ent must be recorded and posted on the jobsite
bei a the first inspection. If you 'ntend to obtain financi , consult wit lender or an attorney before
com encin w rdin r Notice of Commenc . ent.
Signaof ssee Sig ature o Co ra ice se Hold
STATF F RIA STAIE OF 0RDA� ;
COU;O `e- COU T OF
The forgoing instrument was a knowl sed�b,�fore me The f rgaing inst u ent was a f know_ledged before me
this day of 20 V by this r day of 61Y1�x�` 20�by
Q5�
1
(Name o er acknowledging (Name of person cknowledging)
nature onature of No
V4,µ,�,ur, JERAL E U S
�p�tpaY PUef ri ALYNNE RUSSELL 11 �e%,
Personal) K w - ®� dbBiyUredBttoffiditbn Personal) Kno � R is
Type of Iden _•.q, d6omm.Ex fres Jul 22.2017 Type of Identlfl �ea� � ll ° ""
•,sop�� � Commisslon#FF 038392Qp �;••'` Commission FF 38382
Commisslon Commission No ea
Revised 07/15/2014
s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS