HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABL INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� �/o Permit Number:
Building Permit Application
Planning and Development krvlco
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: MN Cara D/�U517 iIQC�
Legal DescriptionR)p Ac Dille e Puol !1 �� P. rweS "!/0/
Property Tax ID q: (.ot No. IN
Site Plan Name: $lock No.
Project Name: Wnnaii /c
Setbacks Front Back: Right Side: Left Side:
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Additional work to be ertormed under this permit— check allS apply:
❑HVAC Gas Tank []Gas Piping u_ Shutters ❑ Windows Doors
Electric Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ l q� Utilities:ElSewer Elseptic Building He6ght:
Name Name: 11'' f% rr�5
Address: Company:N� j � bl��
City: State:_ Addres�`ip/ ��e� �f
Zip Code: Fax: City: �IVI�L��21't� / State.
Phone No, Zip Code:727 l l� 1 7Fax: &O
E -Mail: Phon Ng ,.I. 1``�IJ�_It-�-k '-��"''
Fill in fee simple Title Holder on next page ( if different E -Mail C N! ' IkTwa A Vuiir '' ceI n
from the Owner listed above) State or County License:l
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:
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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 thesubject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may resrict 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 paging twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If ygp intend to obtain financing, consult with lender attorney before
commencing work or recc your Notice of Commencement. —
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE I FLORIDA QVm Q, n
COUNTYY OF ,f ���
The for oinginstrum�^e(XAAt%%as acknowledged before me
thisdaI C1" nn ''. 20 & by
;4aA/)U & I VL�
(Name of person ac owledgi )
A,
(Signator ANotu"i,e.`.ra0
Personally Known
Type of Identificat
Commission No. "".
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
MELANIE JOHNSON
STATE OF FLORIDA
COUNTY OF (� (k(1"(�( ROM
Q- , rh
The for oing instrument ^� as acknowledge efore me
this a day of 00( . 20 � by
J�
(Name of person acItn wledg )
LAJL&1(�� "
(Signat a of Notary PLW- State of Florid )
.PftNr@dbIderWc8t1bFridai Personally Known ",,,
Conmissicn # FF 197676 °
� Type of Identifica
My Comm Expires Apr 20, 2019 ;_•; ;
Bondzcrhrou � al Notary Assn 6 Commission No. ai
ZONING SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW REVIEW
commission # FF 197676
7 Comm. Ex{� dJ{jr 20, 201?
rdetl!hmgh N tional lJrtary.4s,
I
SEA TURTLE MANGROVE
REVIEW REVIEW