HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATIdON TO BE ACCEPTED
Date:. .; 11011 Permit Number:
Building PertnitApplication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CommQrcial Residential ✓
PERMIT APPLICATION FOR: To Select from drgptipx, click arrow at the end of line
Address: Ir)I Fa -sl- t'S,1bbe rA i'oz+ 5-7t L✓e;c- GC. 34(rsa
Legal Description: ,27 31n �0 4tl I&I�rr P:,, - /y,) ad la a DS2'Gess
15 in ARS 2519-1312: 2513 -24-3b6 L923:Z 47?S.9"tls'.'2551-Irofr;79Y6-ZYS'3-AJ6-7t'
Property TaxlD d: r .�3'- III - f70D D:b -.$- - �i�fpl�i.w„s �. Lq L. Lot No.
i Site Plan Name: Block No.
l Project Name:
Setbacks Front Back: Right Side: Left Side:
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Total Sq. Ft of Construction
Total
!lFt. of First Floor:
❑HVAC 0I�I/GGas Tank ❑Gas Piping
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utt
❑Windows/Doors
Electric LL�Plumbing ❑Sprinklers
❑Generator
Roof
Total Sq. Ft of Construction
Total
!lFt. of First Floor:
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Cost of Constmction:$ �QJ �% utilitiesi:11
Sewer❑Septic
Building Height:
Name / LU_/
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Fill simple page
from the Owner listed above)
State or County License:
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If value of construaion Is $2500 or more, a RECORDED Notice of Commencement is required
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicz
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 Count akes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is In can liet with any applicable Home Owners Assocration rules, bylaws or an 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 resu in your paying twice for
improvements to your pr rty. A Notice of Commencement must be recorde d posted on the jobsite
before the first inspec you intend to obtain financing, consult with len an attorney before
Commgpcigp/work or ipg your Notice of Comme teemen (i
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged fore me
%n
this Qday of a�t.G . 20_W by
edging) Name of person acknow edging) �T/
(Signature of ary Public -St/att arid.
Person Known_ 6KProducedldentiflcation_
Type of ldennficat _
1 r e y LESLI D ZELAYA
Commission No y COMhil l #FF1 1 172
T 6 ` EXPIRES October 1, 2018
.++ r1onaervMeryaemce.com
Revised 07/15/2014
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
COMPLETE
0 INITIALS
Sldnature of CoAtralt6IfUlense Holder
STATE OF FLORIDA _
COUNTY OF
The forgoing instrumen was acknowledged efore me
this /q day of iL 20/by
i3 r� 1gg �`) / 7
amt of erson aacknowedging
(Signature of N✓o u61ic-State ofF da�
Personally Known OR duced Identification_
Type of Identification Produced
Commission No. j4A °`F,LESr7,ELAYA
MY COM ISSI N#f F1 c. 1'!2
n _.. a"�' EXPIRES Oclobe! 1, 2018
IraIIJ�•ar SJ FlorltleNoleryServke.cam
SUPERVISOR I PLANS I VEGETATION I SEA TURTLE MANGROVE
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