HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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g and Development
g o6d Code Regulation Division
ii Virginia Avenue,Fort Pierce FL 34982
Phone- (772)462-1553 Fax:(772)462-1578 Commercial Residential
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Legal Description. t
Site Plan Name:. Block No,
Project Name-.!�__k SLXOU�CAL
Setbacks Front Back: Right Side: 1.6ft Side;
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Total Sq. Ftof Construction: 2_e?:)Z,2_ SCI.Ft.of First Floor:
Cost of • r
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Phone No"M
Fill In fee simple Title
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Holder on next ._ different
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1111 laigug,1;11
DESIGN~ ENGINEER: Not Applicable MORTGAGE COMP4NY: Not Applicable 5
Name: Name: !` i
Address: Address:
City: State; City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name: II
Address: Address: P
City: City.
Zip: Phone: Zip: _ Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit. {
St.Lucle county makes no representation that is granting a permit will authorize thepermitholder to,build the subject structure
which is in conffllict with any applicable Home Owners Association rules,bylaws or an covenants th?t may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any'iestrictioris 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 pians,the Florida building codes and St.Lucie county Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room addltlons,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses io another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencemen#may r�esuit In your paying twice for
Improvements to your property.A Notice of Commence ent must be recorded and posted on the jobsifie
bef a the first inspection. If you'ntend to obtain financi consult wit lender or an attorney before
com encin w din r Notice of Commenc ent.
II
Signat a of ssee Sig ure o Co tra ce se Nold
II
STAT OFF O STA E OF OR'" ��
COU O l COU OF 0�_ ,I
The forgoing instr nt was acknowledged before me The forgoing instrume was acknowledged before me
this day of 20? this day of_ J '' 26 Y
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{Name of erson acknoW dging} (Name of n acknowledgi )
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0 Q—S,
ignature o otary Public-State of Florida nature of Notao Public-State of Florida j
Personally o OR,I@rado"RU&>g.Il<icat'to Personally Known i'd PPduce tt fi�#i
Type of Ide i� i =dt4Cp*1 public ,state of Florida Type of Identification P °'.% J6RQIYN Is
•= Camm.Expires Jul 22.201 :;. = Jatdr u61ic-
Y l' State Of Florida
Commission ,. 4°# e[ P392 Commission No. f +,� „7i11••• iY Corg�gires Jul 22,2017
Commission 0 FF 038392
Revised-07!15/2014
i II,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW • REVIEW REVIEW f; REVIEW REVIEW
(DATE I'
COMPLETE i
INITIALS j