HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MOST BEOMP ETED FOR APPLICATION.TO BE ACCEPTED,
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Date: � � � Permit Number:
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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
PROPOSED IIVPROVE�VIENT�}LOCA ION4 , z,F ti' l,g f :
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Address
Legal Description:
Property Tax ID#: 44 oe)o i - 0o® — C Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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itional worK to be nertorMed Under this permit-c ec
na appy:
=!HVAC Gas Tank Gas Piping _Shutters (�Windows Doors
Electric .Plumbing Sprinklers F]Generator F]Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ ) J C�r� r Op Utilities: Sewer Septic Building Height:
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Name kobpf gn LA e-Q Name:
Address: Company: C � C
City: .� State: Address: cko -Q--
Zip Code: 134-1?•' — Fax: city: '�1 t� c..tt1"� t Stater c�
Phone No. I� q Zip Code:_ c f moi - Fax:772 4 61$" )SS7
E-Mail: Phone No. "7-7.1— .4 fal;( - �9-( 9(10
Fill in fee simple Title Holder on next page(if Aifferent E-Mail: K cC)Oi C) C Cil
from the Owner listed above State.or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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r 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: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or i6stallation.has commenced prior to;the issuance-of a permit.
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St.Lucie County makes no representation that is.granting a-permit.will authorize thepermit-holder to build the subject structure
which is in conflict with any applicable Home-Owners Association rules,-byl.aws.or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners:Association and reviewyour 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:roomadditions,
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 wok or recording our Notice of Commencement.
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Signature of Own /L sse Contractor as Agent for Owner Signature of Contractor/Lic nse H lder
STATE OF FLORIDAc STATE"OF FLORI
COUNTY OF .--•l�`�C� ._ COUNTY.-OF A A 0
The f r instru nt was acknowledged efore-nte The-forgoing instrument was acknowledged before rite
this�y of C:}- 20 acknowledged
this ay of �Q ! ! 20 by
(Name of person acknowledging) {Name of person,acging).
{Signatublic-State of Florida) (Signature of o ary Piubl' -State of Florida)
ersona ly vUrj, ti c ion Personally Known �/ OR Produced Identification
LA M HUFF Type of Identification Produced
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- ate of Fforida
N^ a Commission# Commission No.r r DOI� s
Comm"ssib'r �o¢;° My Comm t.. FF 23{e ) ,sr� •• ea STACEYGARCtA
"„l",° 9ondedt��fesMay27,201£ '�R ”`
9h National Notar ,+: MY COMMISSION#FF 006828
:,� EXPIRES:May 16,2017
•Af.�C ` Bonded
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS