HomeMy WebLinkAboutBuilding Permit Application PTED
ADatePPLICABLE INF MU BE COMPLETED FOR APPLICATION TO B PeCmE 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, click arrow at the end of line
PROPOSED M' P�ROVEMENT LOCATION -
Address: `S N S i 2
Legal Description:
Property Tax ID#: ��-Zc�- ��� - ��- ow _C) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED-DESCRIPTION O,`F WORK t
Df e h�-W 4t) NS
CONSTRUCTION INFORMATION
Additional work to be nertormed under t ispermit-c ec all[ appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
MElectric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �(�V`� Utilities: _Sewer O Septic Building Height:
-OWN CONTRACTOR:
Name Ne M AA 0 1, LL Name: ,..�
Address: 1" e-�� Comp.any; ...,: ...: 1 L ^f
City: ������-t� State:_F. Address: QUO l UI
Zip Code, Fax: City: �.� Stater
Phone No. 2—Sa2-1(q 7_ Zip Code:3L46k- Fax:
E-Mail:
E-Mail: Phone N
Fill in fee simple Title Holder on next page if different E-Mail: o X�( Q� � - �C�_1�1 (a Cbl
from the Owner listed above) State or County License: ��(�
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required:
.:SUPPLEMENTAL CONSTRUCTION LIEN,:LAW INFORMATIOW
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. c
s
_Sig �turof Owner/Lessee/Agent Si at a of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ,�1 X41
COUNTY OF �_ — COUNTY OF IC
The forgoing instru ent was acknowledged before me The for oing instr ment was acknowledged before me
this ray of 20 �by this day of 1A 20 by
\�Con
(Name of person acknowledging) (Name of person acknowledging)'
(Signature of Notary Pub ic-State of Florida ) ( ignature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission N 23 � 'on No.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS