HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: sizi Ito 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, click arrow at the end of line
Address:
Legal Description: K i 'vv
Property Tax ID #: ` "4%1Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
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141,5 5e-iDk�
iamo work to I,e ertormed under t is mit= cl
VAC Gas Tank []Gas Piping
11 Electric ❑ Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction. $—&f3
f3ct
Lot No.[
Block No. 1 6)
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iamo
A-
anh apply:
OGenerator Shutters
5 Ft. of First Floor: _
Utilities:Sewer Septic
Windows/Doors
Roof
Building Height:
Name CSP' Name:
Address: & Company:
City: State: Address: J.
Zip Code: _ ax: City:. y- �_ �l �-"�%L-'�.— State: F[_
Phone No. -7�. — toc, 7 - � �7� Zip Code: 5061 ??_ Fax:
E -Mail: Ili L4 Phone No. -7?2 - wig- 33-7?
Fill in fee simple Title Holder on next page ( if different E -Mail: U'1 C16W 56 [ 0 (.'Com
from the Owner listed above) State orCounty License: CA j 57�'i
4;t�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City:
Zip:
Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Applicable
State:
V Not Applicable
St. Lucie Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
commend work or r ording your Notice of Commencement,
r/ Lessee/Agent
cense
STATrOF FLORID!!, �� STs4TE OF FLORI j r
COUNTY OF �0 ii COUNTY OF ¢-. h uta
The for oing instrum t was, acknowledge before me
this a day of 20 1 --by
I !a� 1%
{Name of person acknowledgin )
-126� �'. , �YA16eL
(Signature of Notary Public- State o Florida )
Person,V' D&' "" �'° `" ,R Fr'o� ► �1 ii ficrfr!/
Type of Identification Produced .��� 1S1•°•.; C' '•
�I
Commission o. -3�* ; `(Seal)—
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�, �_ AFF i4�va7
s 3'f •;;'tended ltinf
Revised 07/15/2014 ''�,A�R •r:;;�;;
The forgoing instrument was acknowledged before me
this day of 20 by
(Name of person acknowledging }
(SignatueA�rly�LEbli Sttgf Florida)
Personally Known OR Produced Id jj n
Type of Identification Produced ��►t�®���ii..
`fir �•r..a
Commission No*
FF to, 5 :'R004
REVIEWS FRONT ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
VEGETATION SEA TUFff#til#I`IffXNGRO
REVIEW REVIEW REVIEW