HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1lJ}o cp Permit Number.
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia.Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax- (772)462-1578. Commercial Residential
PERMIT APPLICATIIOp�N` FOR:. To Select from dropbox, click arrow.at the end of line
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Address: � epi`
PropertyTax:ID#:,3�j' " b& 1 " DQP-7 Lot No.
Site Plan Name: Block No.
Project.Name:
Setbacks Front Back: Right Side: Left Side:
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itio wor to e e orme un_ ert is permit=c ec a appy:
- HVAC F1 Gas Tank []Gas Piping. _Shutters F]Windows/Doors
Electric. .Plumbing Sprinklers Generator n Roof
Total Sq Ft of Construction: S .Ft.of First Floor:
-Cost of Constructions°$ utilities: Sewer aseptic Building Height:.
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Name-' c5 . . , Name: - ± ✓'
Address: Company in i
City •�Ut' ( Inc Ui C'__ Stater Address £���
Zip Code: J., fax: City: State;R.
Phone No tC J� I Z Q. Zip Code: 13WD- Fax ocb_4, l i
E-Mail: Phone.No. V1
Fill in fee simple Title Holder on next page(if different E-Mail: `` ryl �" C�iYYI
from the Owner listed above) State or County Licenser 1
If value of construction is$2500 or more,a RECORDED Notice of.Commencement is required.
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DESIGNER/ENGINEER: � otAppiicable MORTGAGE COMPANY: otApplicable
Name:. Name: -
Addresst Address:
City: State: City: State:
Zip.: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:-. _ of Applicable BONDING COMPANY: _ of Applicable
Name: Name:
Address: Address:
City: City:
Zip: .Phone: Zip: Phone:
[.Certify that no work or installation.has.commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is&anting 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,.)do hereby agree that will,in all respects,perform the work
in.accordancewith 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:and :posted:on the jobsite
before the first ins ctior
n. If intend to obtain financing,consult with lender an attornoV before
commencing wpot or,recording ourNotice.of Commencement.
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et/lessee/Agent 5 Yaetor/License Holder
SITE N OF FLOR �I / STATE OF FLORID�4. C� (
COUNTY OF( 7`` L�lot.C-4 Q._, COUNTY OF_�
The fo oing instru nt was a knowledge pefore me. g instrum t was ac powledge efore me
The for in r 20 by
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thisday of - Q 20by thisday of
JOAN .n a �J
(Name of..Person acknowl dging) (Name of person acknowlial�ing)
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(Si f ry�WnR
ate of Florig PQ�R•, . C s (Signature of Notary Public-State of Flc� \N.
sioN SABRiNA.LfitACK ��� �'.••��e�$IOIy'••.;�
Personally Known Produce Idq fw' vt1 n2° Personally Known 11// OR Produ�d
Type of Identification Produced = ZF`�� N• , Type of Identification Produced
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Commission No s(SIL #FE 195337 Q Commission No: - � y;(SF}19 •ae`
'lr 5337
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Revised 07/15%2014 ,
REVIEWS FRONT . ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE.
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS