HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACaPTED
Date:
Permit Number;
RECEIVED
Building Permit Application JAN 2 0 20%
Planning and Development Services PERrAITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
APPLICATION FOR: To Select from dropbox, click arrow at the end of line •
3S.
ProperLyTax1D#',744'?'- Lot Nd.
Site Plan Name: Block No.
Project Name:
Setbacks Pront Back. Right Side: L6ft Side:
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a i ion rK to—be dd-—under fff-is permit-checK all U7.1'.apply:
HVAC GasTank DGas Piping Shutters WindoWS/Doors
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]Sprinklers Roof Electric Q Pluming F
Total Sq.Ft of Construction., S Ft of First Floor:
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Cost of Construction:$ 7- 1c_ Utilities Septic Building Height:
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City. V!�M State:,P!(— Address:UIR)I
zip City:
Fax. State.
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Phone No,_-7_-2-L-qW- LZIS, Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different. E-Mai : &�=kK3
from the Owner listed above) Stateor ountyLicense;P11K.0 _72.
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1f,value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Ad dress: Address:
City: State: City: — State:
Zip: -- Phone: Zip: —_-- Phone-
FEE SIMPLE TITLEHOLDER: ^,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 Coun 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 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
imp ovements to.your property.A Notice of Commence a it must be recorded and posted on the jobsite
bef a the first inspection. If you 'ntend to obtain financi ,consult wit lender or an a orney before
tom encin w din r Notice of comm ncetrient.
Slgnat re of a ee Sig a ure o Co tra ce se Hold
STAT OF F O STA E OF 0 A
COU 0 1 Q. COU OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this'Z�day of C?� Xt/c 20�by this'l, day of ['.v^v 20 by
(Name of pers acknowledgin (Name of peAon acknowledging
7erso
ature of N ty Public-Stateof Florida) (Si tune of Notary P ic-State of Florida)
nally Known O P c 'fi ti personally Known
Type of Identification Pq� l.,, , Type of Identification Pro c "9p
-,� Notary Publit-State of Florida
Commission No. _ = Nat lit-State of Florida {tyAaI)Expires Jul 22.2017
commission No.
��• �; try G,mm.Expires Jul 22,2017 =;, Q�-
��FO�F�.�� Commission#FF 039392 ''•;; o;�.•` Commission#FF 038392
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS