HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date: 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
PRQPOSED 0 R
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Address:
.'Legal Description:
Property Tax lD#: 3qoq_:10']_ Lot No. z
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED
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CONSTRUCTION INFORMATION C ibN*
Additional work to be D rtormed under this permit—check all apply:
11HVAC Gas Tank DGas PipingShutters F1 Windows/Doors
Electric
1`7A 0Plumbing F ]Sprinklers FiGenerator F� Roof
LZ�$
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cp
Cost of Construction:$ Utilities:cn Sewer F]Septic Building Height:
OttUNER/LESSEEr`
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XONTR
Name E_X.kA(-1Vri �&N(Inhn Name:
Address: Company:
City: State: Address:
Zip Code: Fax: City: 0, State:,
Phone No. n:z, o� —�N—Vt
Zip Code: 15LAK?_ Fax-IT?TZ ALK-A-L4
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E-Mail: Phone No. L4(o(- '95'L
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION"LIEN'LAININI=0RMA1`ION j .. �`&� � ° ��� � �u���
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: 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 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 recording our Notice of Commencement.
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DATE
COMPLETE
INITIALS