HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.PPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: _
Legal Description:
Permit Number:
Building Permit Application
Commercial Residential
Property Tax ID #: U 1 i 1 OD D o0c) - `J
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
eer
ditional worK to be pertormea unaer ims perum – -mur, all L, Y-
-Mechanical _ Gas Tank — Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ % e"
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
Name LL) i M I ' 1-A'
Address:
City: �k `�� l t P State: EL -
Zip Code: rr` Fax: I
Phone No. ILIJ"I ✓ _ U �lU
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Lot No.,_._
Block No.
Windows/Doors
Roof
Building Height: _
Name: Ltxrtl5 s0.ur►rnon S
Company: bus Td m A L L S ffe rS NC,
Address: (ctA v r"
City: PC e ---T- S r LL1tC State:
Zip Code: 49s�j Fax: �g; 33S �b
Phone No.—
E-Mail: C '� r qt,01.
State or County License:
If value of construction is 25edor more, a RECORDED Notice of Commencement is required.
— Not App
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
r;+.,•
Zip Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
ssttrucctture. Please consult with applicable
Home Owners AssAssociation
iiation and review your deed for any restrictions tions which maor
apply obit such
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 record' y your Notice of Commencement
Signature of Owner/ Agent/ essee I Signature of Contractor%License Holder
STATE OF FLORIDA
COUNTY OF �I_ A � k�' �C' La�
STATE OF FLORIDA ,,
COUNTY OF J � L_� s C-_1 l a��
The forgoing instrument was acknowledged before me
this . �'> day of,i, � `HCl P . 20_1.,rp by
V-4-, (' a ►,, e_.5
(Name of person acknowledging)
/pIF
(Signature of Notary Public tate of Florida )
Personally Known OR Produced Identification
Type of identification Produced
Commission No. t F )'; 95
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
The forgoing instrument was acknowledged, before me
this day of ,_) � - 20_J_��by
e
(Name of person acknowledging)
(Signature of Notary Publi - tate of Florida )
Personally Known '' OR Produced Identification
Type of Identification Produced
DEBRALAONES
My C06MIISSION t FF 22 575
EXPIRES: September 5, 19
SUPERVISOR PLANS
REVIEW REVIEW
ar DEBRA L, JONES
No. t" �'l`�rl� �••' I) my COMMISSION # FF Z
EXPIRES: September 5,
"F Of fw
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW