HomeMy WebLinkAboutBuilding Permit ApplicationALL 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
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
Address:
Legal Description:
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Property Tax ID #: `'j�' �' �.��} Lot No.�
Site Plan Name: �r,� Block No.
Project Name: C� I✓1[ii%
DESIGNER/ENGINEER:
Name: _
Address:
City:
Zip:
ne:
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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
commencine work or recording vour Notice of Commencement.
Sign tur of Own /Agent/ L ss
STATE F FLORID� •
COUNTY OF Arvl tlC
The forgoing instru ent was acknowledged Pefore me
this 0day of 20 LVby
1
Signar f Contra or/Lice se H der
STATE FLORIDA
COUNTY OF PALM BEACH
The forgoing instrt was acknowledged before me
u n
this day of 20_ i�Cby
JQ%(%-1CaVvy1(,P_ `) JOSE RAMIREZ
(Name of person acknowledging) (Name of person acknowledging )
(Signa of Notary Public- State of Florida )
Personally Known �/ OR Produced Identification
Type of Identification Produced
GI CHUCK
Commission No. 'WTARYPUBLIC
STATE OF FLORIDA
Revised 07/15/2014 °F' Expires 4/7/2020
(Sig ture of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
�ILLIAN CHUC„
OTARYPUBI- r,
STATE OF FLora3
Expires 4/7/20;,,.
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VEGETATION
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DATE
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