HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: LQ IILl 1I4� 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:
e_
Legal Description: \i 4()"
4-1A_(+ e
Property Tax ID #l: 34A') -5L) C - O(A C) ) - Qoc E Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
4C ��e �i Vie_
I Le e 8�
Iditio
Vwork to be ertormed under this permit -check a
HVAC Gas Tank E]Gas Piping
LlElectric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3YND-
appiv:
,A-) t4 — -gym M
LJ Shutters F]Windows/Doors
1iGenerator 1:1 Roof
SFt. of First Floor: _
CJtilities:Sewer Septic
Building Height:
N a m e'ir" - ,(_), a,�+-� _5"_ (.,i V D_'V' . Name: f. Ce-;Y-
Address:,-,�q L- -C ` r' Company: cAeJ_-_) C&bl i, int r
City: 42gy-� �S j . State: F-(, Address: ( Zip Code: Code: 3 6( `Ma— Fax: City: EL f , e1► & t- State:
Phone No. �~7 - :� 7 ? - z Zip Code: Fax:
E -Mail: Phone No. %-?.-;)- - x : - 33.7 7 31,74
Fill in fee simple Title Holder on next page (if different F -Mail: a ;i (IM 1 b. A f
from the Owner listed above) Stmt or County,License: 3 J- % �J
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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 thepermit 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, 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 vlork or recording your Notice of Commencement.
ner/ Lessee/Agent
STATE OF FLOR
COUNTY OF_ �, L Le—
The f9rgping inst ent was acknowledged before me
this day ofr 201Le by
(Name of person acknowledging')
62e. , r)
T_411C'6�
(Signature of Notary Publi S f Florida } `\�` kkill !� 1111/1
SABRIIVA La L►� .��Q�•.....,.4C�
Personally Known OR Produced Ider1~fic SSIO
Type of Identification Produced
Commission Nofl' 5 ,3 1 (s&a : �••
�••. #FF 195337
Revised 07/15/2014r, et1C STNN
al
er
STATE OF FLORI d i
COUNTY OF
The forgoing instrument was acknowledged before me
this A day of Tt�� 20 L(.,�_ by
(Name of person acknowledging)
ipA--,ic;�O 7J—L
-
(Signature of Notary Public- State of Florida }
Fi R I NA L..+dr- �t)E►►�II►rH�n��i
%sone nown 1l� OR Produced Iden�oYW+I,B(Q„!+i
f'Epe of Identification Produced y�� c,P_.�:•cctne_•.
Cad .,sty 2, F`
mission No. R"15337 �;ea'" J
y. �rF ts5337 : e
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
DESIGNER/ENGINEER:
of Applicable
MORTGAGE COMPANY: Not Applicable
Name:
REVIEW
REVIEW
Name:
Address:
REVIEW
DATE
Address:
City:
State:
City: State:
Zip: Phone:
COMPLETE
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
INITIALS
Name:
Address:
Address:
City:
City:
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 thepermit 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, 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 vlork or recording your Notice of Commencement.
ner/ Lessee/Agent
STATE OF FLOR
COUNTY OF_ �, L Le—
The f9rgping inst ent was acknowledged before me
this day ofr 201Le by
(Name of person acknowledging')
62e. , r)
T_411C'6�
(Signature of Notary Publi S f Florida } `\�` kkill !� 1111/1
SABRIIVA La L►� .��Q�•.....,.4C�
Personally Known OR Produced Ider1~fic SSIO
Type of Identification Produced
Commission Nofl' 5 ,3 1 (s&a : �••
�••. #FF 195337
Revised 07/15/2014r, et1C STNN
al
er
STATE OF FLORI d i
COUNTY OF
The forgoing instrument was acknowledged before me
this A day of Tt�� 20 L(.,�_ by
(Name of person acknowledging)
ipA--,ic;�O 7J—L
-
(Signature of Notary Public- State of Florida }
Fi R I NA L..+dr- �t)E►►�II►rH�n��i
%sone nown 1l� OR Produced Iden�oYW+I,B(Q„!+i
f'Epe of Identification Produced y�� c,P_.�:•cctne_•.
Cad .,sty 2, F`
mission No. R"15337 �;ea'" J
y. �rF ts5337 : e
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLF
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS