HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l A I3 //,6 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 Fi'
Address: 12, QtAecil -4-YVI (f.
Legal Description: (�>20e-en5
Property Tax ID#: H19 — w(— 0A 00 V`w Lot No.
Site Plan Name:
Project Name:
Setbacks Fr
Back:. Right Side: Left Side:
Block No.
Mechanical
I/ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ fS (?
Name
Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof
Utilities: —Sewer Septic Building Height:
Address: 04 &,necr, .inn 0.
City: f%"u State: F -(—
Zip
-Zip Code: Fax:�q .
Phone No.
"ITki I
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
City: e-te Stater
Zip Code: 3Y53,1 Fax: iV%.
Phone No 7%3- 'Ilt - �hS�
E -Mail Q4"e✓ +e ,n c F2
State or County License '�?b`7 `yj
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 andcovenantsthat 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, wails, 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 recordine your Notice of Commencement.
as Agent for Owner
STATE OF FLORID
COUNTY OF �� .
Thefor�o�ing instrument was acknowledged before me
this £5' `day of pec e . 20 -L by
Signator tractor/License Holder
OF FLORIDA
COUNTY OF SI
The forgoing instrument was acknowledged before me
this " day of 201(. by
(Name of person acknowledging) (Name of person acknowledging)
L- - 9-� &'
(Sigre of Notary Public- State of Florida j (5' ature of Notary Public-
Ift
Known E/ OR Pro ntificat(on Personally Known
Type of Identification .o;u p•+y Type of Identification
Produced r'" s Produced
s i No ry JASON M .'
Commission No.(-g655`I.' al)pI�lc SjaaERO(yom scion No.ys'
My Cpe+ip. Ex961 loripa
•
REVIEWS FRONT ZONING SUPER z0? NS VEGETATION
COUNTER REVIEW REVIEW IEW REVIEW
Nor300POpM�
MI( aMn Sli gSON
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*,00/.
SEA TURTLE I MANN
REVIEW REVIEW
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 andcovenantsthat 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, wails, 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 recordine your Notice of Commencement.
as Agent for Owner
STATE OF FLORID
COUNTY OF �� .
Thefor�o�ing instrument was acknowledged before me
this £5' `day of pec e . 20 -L by
Signator tractor/License Holder
OF FLORIDA
COUNTY OF SI
The forgoing instrument was acknowledged before me
this " day of 201(. by
(Name of person acknowledging) (Name of person acknowledging)
L- - 9-� &'
(Sigre of Notary Public- State of Florida j (5' ature of Notary Public-
Ift
Known E/ OR Pro ntificat(on Personally Known
Type of Identification .o;u p•+y Type of Identification
Produced r'" s Produced
s i No ry JASON M .'
Commission No.(-g655`I.' al)pI�lc SjaaERO(yom scion No.ys'
My Cpe+ip. Ex961 loripa
•
REVIEWS FRONT ZONING SUPER z0? NS VEGETATION
COUNTER REVIEW REVIEW IEW REVIEW
Nor300POpM�
MI( aMn Sli gSON
�.
*,00/.
SEA TURTLE I MANN
REVIEW REVIEW