HomeMy WebLinkAboutBuilding Permit Application?PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 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: 1
Legal Description:
Permit Number:
Building' Permit Application
Commercial Residential`
Lot No.
Property Tax ID #:
�
3�� Q 3 �`C',C'i �, — L� �� �_
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
ditional work to be performed under this permit - cnea
-Mechanical — Gas Tank _ Gas Piping
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ -5"1�2-'3
_ Shutters
Generator
Sq. Ft. of First Floor: _
Utilities: —Sewer _ Septic
Names —
Address:
City: fi `�� c P State: F U
Zip Code::311 i�(� Fax:
Phone No. �'1'� - ,3(1:_;� JC14
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
Roof
Building Height:
Name: C'u�it5 SAa�1ri�oYlS
Company: A�� ��tS�einS L
Address: N I (
r ' � Dr
Cit POQ7 L1kc kc- - State: FL
Zip Code: 34SZ Fax:
Phone No. 77�= 33,5 -3g3 2
E -Mail: C 'f C,c 1 .
State or County License: CA C 0 5 I � 10
If value of construction is 2S9�or more, a RECORDED Notice of Commencement is required.
)ESIGNE ENGINEER: — Not Applicable
Slame:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address: State:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
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
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 work or recor ' our Notice of Commencement.
Signature of Owner/ Agent/
Signature of Contractor%License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF l� COUNTY OFA
The forgoing instr ent was acknowledged before me
this fy day of a 20by
(Name of person acknowledging)
(Signature of Notary Public- State 11 lorida )
Personally Known I" OR Produced Identification
Type of Identification Produced
r? COMMISSION # EE 8592E
commission No d `SUA/ EXPIRES: April 4, 2017
s�yrEOF ��QQ°e BondO ThN Budget Notary Ser k
REVIEWS
RECEIVED
DATE
COMPLETED
The forgoing instr4qent was acknowledged before me
this �_ day of 20_& by
v
(Name of person acknowledging)
(Signature of Notary Public -State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
��h' al CHRISTINE B. ENGLISH
Commission No. MY COMMISSION #EE 8592E
* EXPIRES; April 4, 2017
ANGRO
FRONT ZONING SUPERVISOR PLANS VEGETATION S ATRIEWLE MREVIEWVE
COUNTER REVIEW REVIEW REVIEW REVIEW