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: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
V
Property Tax ID #: T�-% Lot No.
Site Plan Name:/ w LL Block No.
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Project Name: o, -'7 -e e :P'i� a LdGZ% (--
Setbacks Front Back: Right Side: Left Side:
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/65'
777777777777777777'
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itio wor to je oej orme under this permit- c ec „ a appy:
a
VAC L _1 Gas Tank
aGas Piping _
Shutters Windows/Doors
Electric ElPlumbing
Sprinklers
FI
Generator
0
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 27,_400-00
SFt. of First Floor: _
Utilities: Sewer Septic
Name D i (Inn Name:
Address: )_q D 3 pine t`C..{_ d o [ . Company:
City: -e)iC) A'eld State-M�[ Address: Ir
Zip Code: 149 Fax: 7�9$ l�/'7Z City: C
Phone No.777,7 % -�'% Zip Code:
E -Mail: Phone No.,Ole IL.
Fill in fe imple Title Holder on next page ( if different E -Mail:
from the Owner listed above) State or C ty License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
u
Building Height:
_ state:
_
Fax:r�'
9 __?Z_4�
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 your Notice of Commencement. /1
_ Signatu n&/ Levee/Agent
STAT ORIDA
COUNTY OF S+ LUC ti E
The forgoing instrument was acknowledged before me
this22 day of --:-Y
"J,9WU 20 Eby
ctor
ST4T,f/OF FLORIDA
COUNTY OF �91 L-Lkc I is,
The forgoing instrument was acknowledged before me
this day of>21, 20 %qJ_ _ by
(Name of person ac nowledging ) (Name of person cknowledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. FFDO
KRISTINA L
Revised 07/15/2014 EXPIRES August 7. 2017
(407) 398-0153 FloridallotaryService.com
Personally Known / OR Produced Identification
Type of Identification Produced
mmission No.
398-0153
ISTINA L
My COMMISSION R
EXPIRES August 7, 2 7
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
DESIGNER/ENGINEER:
_Not Applicable
MORTGAGE
COMPANY: _Not
Applicable
Name:
REVIEW
Name:
REVIEW
DATE
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 your Notice of Commencement. /1
_ Signatu n&/ Levee/Agent
STAT ORIDA
COUNTY OF S+ LUC ti E
The forgoing instrument was acknowledged before me
this22 day of --:-Y
"J,9WU 20 Eby
ctor
ST4T,f/OF FLORIDA
COUNTY OF �91 L-Lkc I is,
The forgoing instrument was acknowledged before me
this day of>21, 20 %qJ_ _ by
(Name of person ac nowledging ) (Name of person cknowledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. FFDO
KRISTINA L
Revised 07/15/2014 EXPIRES August 7. 2017
(407) 398-0153 FloridallotaryService.com
Personally Known / OR Produced Identification
Type of Identification Produced
mmission No.
398-0153
ISTINA L
My COMMISSION R
EXPIRES August 7, 2 7
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS