HomeMy WebLinkAboutBuilding Permit Application r
BuildingMPLETED FOR APPLICATION TO BE ACCEPTED
ALL P CAB INFO MUST BE CO 4--rch,
Da I PIT,!t Permit Number.
Building Permit Application
Planning and Development Service.5
and Code Regulation 1
2300 Virginia Avenue,Fort Pierce FL 34982
♦ ! t • 462-1578Commercial Residential
PERMIT APPLICATION • Select
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•>.l Description:
• .. Lot No.
Site Plan Name: Block No.
Project Name: kf'ah�wd 8"gelt
Setbacks FrontSide: Side:
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2rHVAC Gas Tank [:]Gas Piping
Shutters Windows/Doors
Electric E-1 Plumbing Sprinklers FIGenerator 011cof
Total F of Construction: i Ft.of First Floor:
Cost of Construction: i . Septic
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Phone No.
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Fill in fee simple Title Holder on next page(if different
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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 Associatlon rules,bylaws or and covenants that may,restrict or prohibit such
structure.Please consult with your Horne 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
Commencina work or reco ding vour Notice of Commencement.
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Owner/ essee/Agent Sign o on radar/License Holder
ST FLORID S F FLORID
COUNTY OF A- LAX I e COUNTY OF ltluCA 6
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day ofd 1 , 20 Lle by this day of PXf►1,_, 20 J(p_by
.�� -we�.�-- Cactus srna ntn J e a 6 m5srnr n
(Name of persori'acknowledging) (Name of person ackn wledging)
yoj
(Sig ature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known tr OR Produced Identification
Type of Identification Produced Type of identification Produced
`PYA"~ mission No.�"I-'od ?&,a, AN's
Commission No. � d� '� , TINA L EOUDERB
+� '' NINA L LOUDER K
(Mr aMMrss{ON#f:Foo 22 •� :•r MY COMMISSION#FFO
EXPIRES A ust 7.20 7 p
467{308,0103 Fbridallo Servke.MM °a EXPIRES Auguat 7.201;
Revised 07/15/201.4 do 204153 FlorldallotaryServimco
REVIEWS• FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS