HomeMy WebLinkAboutBuilding Permit ApplicationAII APPLICABTE INFO MUST BE COMPTETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Planning and Development Services
Euilding and Code Regulotion Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772\ 462-1553 Fax: (7721462-1578
.'
Commercial _ Residential V
PERM IT APPLICATION FOR:Shun !e. (nro,
Address: t5t0
Legal Description:
Property Tax lD #:
Site Plan Name:
3\O>-609- OZq?*OOO*9 r_otrrro. t{t5
Block No. < I
Project Name:
Setbacks Front Right Side:Left Side:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
_ Windows/Doors
( Roof\
----Z-Total Sq. Ft of Construction:l>-7s Sq. Ft. of First Floor:tz7{
Cost of Construction: $ \)4,SS . oA Utilities: - Sewer - Septic Building Height: q t
Name Name:
Address:Company:
city: taFt Refce-, State: TL-Address:
Zip code: 3u\q.9 Z-- rr*,cit State: \-t-,
Phone *o. Oa, - S'Oa - 6?-57'
E-Mail:
Zip CodeB
Phone No
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
License
DETAI LED.DESCRI PTION OF WORK:
CONSTRUCTION IN FORMATION :
OWNER/LESSEE:CONTRACTOR:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is uired.
rax'@
SUPPLEMENTAL CONSTRUCflON LIEN LAW INFORMATION:
DESIGN
Name:
ENGINEER:Not Applicable MORTGAGE COMPANY:
Name:
Applicable
Address:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
Signature of rlL
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20_ by
Signature of Contr icense Holder
BONDING COMPANY:
Name:
t Applicable
Phone:Phon
owNER/ CONTRACTOR AFFIDVIT: Rpplication is hereby made to obtain a permit to do the work and inrtrllrtion ,, indi.rt"a
I certify that no work or installation has commenced prior to the issuance of a permit.
St- LucieCounty.makes no representation that is granting a permit will authorize the permit holder to build the subiect structurewhich is in conflict with any.?pplicable Home owfieis Aiiociaiion iuiei,-ut)i;w;oi;;d;;vii;;;i;iir;i,iriv"reiiri.itlo"rohibit suchstructure. Please consult with your Home owners Associatioh and ievi6w'youi deed ioi ffi';e;iriciid;;iiiit.t 'ii,.:v rrip[y -'' """"
ln consideration of the granting of this requested permit, { do hereby agree that I will, in all respects, perform the workin accordance with the approved plans, the Florida Building Codes and 5t. Lucie Couniy 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
STATE OF FLORIDA 1
couNTyor C.tuee--
The forgoing instrument was acknowledqed before me
this 3.\day of t\arab.= . zofu oy
?,-,\i' )a- \ rt'\ .: (_ )r.-T't z
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known OR Produced ldentification
Type of ldentification
Produced
Commission No.
DATE
RECEIVED
Florida )
Commission
(sisnaqgf NotRry Pu blic-
Personally rno*n \ (
ZONING I SUPERVISOR
REVIEW I REVIEW
PLANS I VEGETATION
REVTEW I nrVlrw
SEA TURTLE I MANGROVE
REVIEW I REVITW