HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED,FOR APPLICATION TO BE ACCEPTED
Date: Permit Number::
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 V
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT-APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: \
Legal Description: Sial' &X01Ioir V. I IC.iS ComjO
Property Tax ID#: 35aa,��5 -��1 - �C - Lot No.
Site Plan Name: SQ.r, 1 O Qk' I70 f-P.S Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
1 = CST 3(60 S H ( k) TM P AC-r)
Additional work to e e orme un er t is permit-c ec a appy:
HVAC Gas Tank Gas Piping _Shutters indows/Doors
FlElectric ❑ Plumbing OSprinklers E]Generator Roof
Total Sq. Ft of Construction:p S Ft. of First Floor:
Cost of Construction:$ 7 a 7. 67 Utilities:cn Sewer Septic Building Height:
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Name d- 2ClC. LQSa, �, Name:
Address: 'rill 0 T. (7CS CLn-Dr'• Z 1 Q 1 Company: C V 5�
City: Ems01 �P_Qa. State: PL Addr � t �
Zip Code: 34 5L 7 Fax: City: ^� State
Phone No. 1 g' DI $ -5-D Zip Code: LASS Fax: -1LAS--KS3Z
E-Mail: Phone. �3
Fill in fee simple-Title Holder on next page(if different E-Mail: LLA
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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
commencingwork or r Notice of Commencement.
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_Signature of Owner Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OFZ-�
�Mday
ing inst�nt was acknowledg before me T f oing instrumen was acknowled d before me
20y t�ay o 201 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary\7OR
-State of Florida ) nature of Notary Pu c-State of Florida
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Personal) Known V Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. t mmission No. W o Z__S (Seal)
MELJSA ARMENTO
CAMMISSION#EE 855825
p g EXPIRES-December o MELISA ARMENTO SSA ARMENTO
.. 6?• Bond edThroNotaryPublIoundenvrilers f
Revised 07/15/2014 Pf T"• _ : by coh1MISslON#EE 855825 1.d18:;:JN#EE 855825
EXPIRES:December 28,2016 =o:December 28,2016
_
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROV
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 7 �G
COMPLETE
INITIALS