HomeMy WebLinkAboutpermit application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: O�
Building Permit Application
Planning and Devefopment Servfces
Building and Code Regulation Division
2300 Yfrginfa 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
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Legal Descriptior
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Fill In fee simple Title Holder on next page{If different E-Mail: •� __
from the Owner listed above) State or County License:
it value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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: r,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.
5t.I.ucie County make 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 Assoclatlon rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Horne 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 permlt applications are exempt from undergoing:)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 a •pasted on the jobsite
before the first inspection. If you in eff blain financing, consult with len or an att me e
commencing work or re_co your Not! of en_cement. r�
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r of Owner/Lessee/Agent I n f Co racto TE OF FLORIDA ATE K)F FL�UNTY OF COUNTY OF„_,(_,�.CL Yl��
The0ay'of
ins ent s cknowled before me The instru t was a nowledge before me
lhts �� 20Mt'y thi day of 20 „�,by
(Name of person acknowledging) (Name of person acknowledging)
nlka(� rv\cb 11A
(Sign tune of Notary u lic-State o Florida) t5ignatur of Notary Pub Ic-State of Florida)
Per natty Known-OR Produced identification ly Known�R Produced Identification
pe of identification Produced Type of identification Produced
Commission No. efr41b J&AhETTE HAMILTON commission No. ��y� 111H NTTE HAMILTON
M� l•1.MMISSION H FF949668 My COMMJSSTON At FF%W9
^•xPIRJiS:JanumyV,2020 'mop EXP1R.9s:7auuury07,202o
Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR Pa+4NSVEGETATION 5EATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE _..
COMPLETE _