HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INF MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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 APPLICATION FOR: To Select from dropbox, clickRIM,;
arrow at the end of line
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Address: �3'7.3 a cLd— S L .3
Legal Description: LL_ ' J 5 _<73 46
Property Tax ID#: 3 Y S b "' LY J 0 ' 0 5'6 ( Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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itiona wor to e e orme un er t is permit—check all appy:
HVAC Gas Tank Gas ng _Shutters Windows/Doors
aElectric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 3400" Utilities: Sewer E Septic Building Height:
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SCO RACTOR ti�A �� s 4ffi
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Name: Sco�t- - f,-1Z--)
Address: 3 !� �d Company: kd= P. AAQ�
City: or — Stater Address: LJ
�— Cit J' o C�" �. ( C:� -� State.
Zip Code:34 Cl S Fax' Y� -
Phone No.:Z 7 ' Fax:,- , d Zi %
E-Mail: Phone No. —/U '
Fill in fee simple Title Holder on next page(if different E-Mail: �. S' °�-� o
from the Owner listed above) State or County License: 0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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 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
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA / STATE OF FLORIDA ��G(
COUNTY OF ���-2 COUNTY OF
The r oing instru �e t was acknowledged fore me The forgoing instrument was cknowledged fore me
this day of ` 20 Eby this day of 20 y
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(Name of person acknowledging) (Name of person acknowledging) , rl
(Signature of No ry Public-State of Florida) (Signature of No ry Public-State of Florida) i
ers ly Known OR Produced Identification P a ly Known OR Produced Identification
of o Produced T e Produced
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS