HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABI INFO MUST._BECOMPLETED FOR.APPLICATION TO BE ACCEPTED
Date: Permit Number `CoOw-.O S3`.]
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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 ll//
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description: ,?Q,(1(�. .�bV i I l QS o--Y QO
Property Tax ID#: c)5'0 Li Lot No.
Site Plan Name: I Block No.
Project Name: 36A air S res
Setbacks Front Back: Right Side: Left Side:
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Additional work to a er orme un er t is permit—c ec "11
❑HVAC Gas Tank Gas Pi in `n/Windows Doors
P g '�d /
Electric 1:1 Plumbing F]Sprinklers Generator Roof
Total Sq. Ft of Construction: S . of First Floor:
Cost of Construction:$ L4I,4 • 17 Utilities:cnSewer []Septic Building Height:
Name ht>m k '/�c, Name:
Address: 'THIO S. 0C0'QXQ)r. L09_-b Company:
City: Tp-m-an �M State. EL Address:
Zip Code: 3 4 g 5 7 Fax: City: State:
Phone No. _�5�$ S / — SII ` Zip Code: . Fax: !
E-Mail: Phone No. \
Fill in fee simple Title Holder on next page ( if different E-MailCA&)
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
MIN'
DESIGNER/ENGINEER: _Not Applicable. MORTGAGE COMPANY: _Not Applicable.
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE BOLDER: _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
commencin - ur Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FL RI d,>PzC�
COUNTY OF COUNTY I
T or Ing ins as acknowledg d before me T Ing instrument was ac l owled ed before me
day of 20 y tb��y o 20 y
1 CA
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(Name of person acknowledging) (Name of'person acknowledging)
C� At—.
Ignature of Notary Pu lic-State of Florida) Ignature of Notary Pu Ic-Stat Flo Ida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification
Produced G
Commission No. f�_iJ MELISAARE amiss n No.C O (Seal)
' MY COMMISSION EE 855825
*' EXPIRES:Deco er 28,2016 '"��P` =P)6*)�,f_W'r;
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE ���/ ,�/�j►
COMPLETE
INITIALS