HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � -� � Permit Number:
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Building Rermit.Appikation
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982 _/�
Phone:(772)4f2-2553 Fax: (772)4fi.2-1578 Commercial Resi,denfial
PERMIT ARPLICAT)ON FOR: To Select from dropbox,clic !arrow at the end of line
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Site Plan Name: Block No,
Project Name:
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Additional wor o e vertormed un er t €s permit--c ec a appy:
L 1HV L�J Gas Tank ! Gas Piping _Shutters. Q,Windows/Do.ors
Electric Q Plumbing F-I:Sprinklers Generator ;Roof
Total Sq.Ft of Construction: S .Ft.of First Fioor
Sewer Septic: Building.Height:
Cost:of Construction:$ `{T� R Utilit#es:' a
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Name �- .. Name.
Address' d��t = Company.
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City: ...__ Y t C...�C �' State:I� Addr s,:t:
Zip Code: �� Fa �i. City: d' r State
Phone No. r;
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Fill in fee simple Title Holder on next page(if differen s E-Mail ' ? V' ` •C `'`` r t, itk
from the Owner listed above) State or County-License: :- �; t.
if value of construction is$2500 or more,a RECORDED Notice oftommencement is regdimd.
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DESIGNERiEIVGINEER: ____ ;of Applicable MORTGAGE.Ct)MPANltt :Not°Appiicab1e
Named Name•
Address: ! Address:
City: State: City: State:
Zip: Phone 1 Zip: _ Phone:
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FEESIMPLE TITLE HOLDER: _:[Uot Applicable BONDING COMPANY: _Ndt:Applicable
Name: Name
Address: Address:
City: City
Zip. Phone: 'Zip: Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit.
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St.Lucie County makes no representation that is-granting-a pi sn it will authorize the ppermit 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 deedforany restrictions which may:apply.
In consideration of the granting of this requested permit,.[do hereby.agree thatl:will,In all respects,perform the;work
Waccordance with the approved plans,the.Florida Building Codes and St.Wei e:tou nty'Am end men ts.
The following building permit applications are exempt from undergoing a full concurrency�review`room.additions,
accessor structures,swimming g pools,fences,walls,signs,screen roams and accessory uses to.another non-residential use
WARNING TO OWNER:Your faiilure,�o Record a Notice of:Commencement-may result:in your pay ngturice for
Improvements to your property:A Nance of'Cammencement must:be recorded and.posted.onthe jobsite
before the first inspection. if you intend to obtain financing;.consu.lt with lender or an attorney,before
commencing.work or recordingour'=, Notice of Commel ceme'nt.
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_Signature of Owner/Lessee/Agent Signature of Gantractor/license Holder
STATE F STATE Ot 00
COUNTYOF- i s COUNTY OFMLleoll
The'for oing instrument was cknowledge be ore me The fo ng:instrumenf w,a acknouriedged.before me
this 'day ofti. uo' 20 Eby this day:,of .f f�rlf .20 by
(',�t)poa+n 0, VJW(i 0 t1h A
(Name of p on acknowledging) i (Nami of per± n'acknowledging)wj
(Signature;of Notary Public=State of'Flonda'.) (Signature of.Notary.,Pdblic State:of Florida) <N
crs m.o
Personally Know
nOR Produced Identification Personally Known (.!' 4R`Produced,Identiflcation .a
Type of Identification Produced Type of Identification Produced _-:Cn
Commission Nott Y j (S�ea!) Commission.No 6132 3 - ( eal} u
opu`lto i�iC01e McMahon rpt-.;, NiC3
t!�'Y p�F: �.* tg
o:: M 115Si0H EE132035. 1,32035
e=EXPIRES, SEP 20, oQe-EXPI4
Revised 07/15/2014 ''-'� ��'vfWV,.ARONNQ?ARY.com n.•�''www.;': rnitvgorc>:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA'TU,RTLE MANGROVE;
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