HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
Date, Permit Number:
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RECEIVED
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Building Q
17
Pionningr Devg1opment
County,Building and Code RegUlarlon Divisign St. Lucie
ff Virginia Avenue,Fort
Phone: ♦ ♦2-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Legal Description,
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name-, j
Setbacks Front- Back,____.Right Side., Left Side:
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Electric • • ' ■ hoof
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Cost of a aUtilities: - Septic Building Height:
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■ . Zip Code: 4 * i � III' um# r
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• - No. f
State or / -
if value of can �tion1 i or • / Y Notice of Commencement - •e
py
DESIGNER ENGINEER: _Not Applicable 1410RTGAGE COMPANY: —Not Applicable
Name- Name:
Address: Address:
City: State: City: State:
Zip; —Phone: Zip: Phone:
FEE SIMPLE TITLlr 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.Lucle Counmakes no representation that is granting a ermit will authorize the ermit holder to I wild the subj?rt structure
Which is in conflict with an applicable Homy Qwners AssocrOon rules,bylaws or anycovenants that may restrict pr prohibit such
structure.Please consult w th 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,fer;ces,walls,signs,screen rooms and accessory uses to another note-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 mint 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 our Notice of Commencement.
s
si erl Les ee/Agent Sign of Con dtor/License Fielder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgging instr meat was acknowledged before me The forgoing Instr ment was acknowledged before•me
this/ day of L _, 21117 by this.1_day of_ Iu20 1'7 by
(Name of person acknowledg' .) (Name of person acknowled ung)
v
5ignawre of Notary Public- e
,f Florida) ( gnature of Notary Public-St
Personally Known f:fqR Produced Identification. Personally Known 1_ oR Produced Identification
Type of Identification Produced Type of Identification Produced .
Commi Gr.�drrrl Co isg� ;.r�„ b�
Yid � --�. NZ RUE �Se
GEtip LOC.
RE AUF =` * +s Notary_Publia-State.of Florida
a 6om `:`til fes Feb 7.2020
Oeetmi9sioa FF 88lBBy': . 1 ,
Revi fit .0 comm.Expire�r 46.7'�ppp �*!!.
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REVIEW$ FRONT' ZONING' SUPERVISOR PLANS' VEGETAnON SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
=iNITIAL$