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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Planning and Development Services Building Permit Application Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Fl. 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial —� Residential PERMIT APPUCATION F©Ft To Select from dropbox, click arrow at the end of fine Address: © (p Legal Description: LoI. e,5 P-) I -V- & i�d� j l� Property Tax ID #: :3 v �3 -f .r F, -f - Lupi gam; J Site Plan Name: Lot No. Project Name: _Env� Block No, Setbacks Front Back: - _. Right Side la Crr?- Prvj I N E� Sciz Left Side: -ey— lq" STA- A4,°--- jur iurrnea under this permit -c" SM ' I2HVAC nPlumbing app y -Gas Tank ❑Gas Piping ShuttersElectric sprinklers Generator Total Sq. Ft of Construction: Cost of Construction: $ S Ft. of First Floor: i ( "r" Utilities: 0Sewer Septic Name �inu.s � 0f ,, - Address: q ZD(v City: fl �k s,- wc..( e, State:✓ Zip Code: 6(a Fax: Phone No. 41 u - ff3 � q ic;-4 E -Mail: urn Ork:„� Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Windows/Doors �r Roof Building Height: __ Name: Company: '�� 1�! Address: ) City: '(T �&t LLIC,� State:t =�-• Zip Code: Z5Lq�53 Fax: Phone No. "77owl E -Mail: State or County License: j 11 vague or construction is $2500 or more, a RECORDED Notice Of Commencement is required. d If km GNER/ENGINEER: _ Not Applicable Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone; State: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: `Not Applicable Name: _ Address: City:_ Zip: I certify that no work or installation has commenced prior to the issuance of a permit. Phone: 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, wails, 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 commencin r recordi Wr Notice of Commencement,­­- - ommencement,,-- — _ Signature of Owner/ Lessee/Agent Signature of Contractor/License Ho STATE OF FLORIDA STATE OF FLORIDA COUNTY OF p-fCA—kCA—k-.1 �-COUNTY OF 'PQ tr_� o Lt CA The forgoing instru- ent was acknowledged before me this 13 day of _ 20( (by (Name of person acknowledging) (Signature of Notary Public- State of Florida ) The forgoing instrument was acknowledged before me this L,3 day of ` fes_ 20 /�' by DauIo E i r)Jey- (Name of person acknowledging ) ,;- (Signature of Notary Public- State of Florida ) Personally Known_ OR Produced identification _ Personally Known_ OR produced identification Type of Identification Produced Type of identification P o Commission No v LINDA MARI BOUCHARD uiVUA MARIE CHART] MY ca�{if ( Commission No. %. MY COMMISSION #FF125526 N #FF125526 '�aFnmQ;,' EXPIRES May .P FXPIRFS 018 _. (40753uar,�� _ Y21, 2018 Revised 07/ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW COMPLETE INITIALS