HomeMy WebLinkAboutBUILDING PERMITALL APPLICABLE INFO MUST 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 fl34982
Phone: (772)462-15S] Fax: (772)4G3 -157O CQOO[Me[CiG| Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
Property Tax |D#: Lot No.
She Plan Name: Block No.
Project Name: FIALM)CY C)
Setbacks Front Back: Right Side: Left Side:
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Total Sq. FtofConstruction: Sq. Ft. of
Cost ofConstruction:$ Utilities: |__)Sexxer|]Septic
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Phone No.
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction is $25O0ormore, aRECORDED Notice ofCommencement isrequired.
Building Height:
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DESIGNER/ENGINEER: _)�L Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
VEGETATION
Name:
MANGROVE
Address:
COUNTER
Address:
REVIEW
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
%C Not Applicable
Name:
Name:
Address:
City:
Address:
City:
INITIALS
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 1 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.
nature of Owner/ Lessee/Agent ignature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF `A - t.. _'k(iC COUNTY OF *� J U. J(;iCy,.
The forgoing instrument was acknowledged §efore me
this IC day of 20 r by
of person acknSTATEF" .. s **« F� .T
VQ��' P EXPIM M=19
Public- State of Florida )
Krsonally KrlovQn
entification Prod
Commission No.
Revised 07/15/2014
OR Produced Identification
(Seal)
The forgoing instrument was acknowledged before me
this M day of 2 U 20 A by
tuYe of Notary Public- State of Florida )
Personally KnoOR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS