HomeMy WebLinkAboutBuilding Permit Application Jul 14 2017 03:46PM HP Fax page 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: All Permit Number:
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Building Permit Application
Planning and Development Services
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Building and Code Regulation Division St. L uc.ie C=Qtinty, FL
:2300 Virginia Avenue,,cart Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select frorn dropbox, click arrow at the end of line
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Address:
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j Property Tax ID#: Lot No.
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Site Plan Name: Block No,
Project Name: _
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Total Sq. Ft of Construction: tt S Ft, of First Floor:
Cost of Construction:$ 1� 4 Utilities:Sewer t_=!Septic Building Height:
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Fill In fee simple Title Holder on next page(if different E-Mailfl, - cxY1
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
-Jul 14 2017 03:46PM 'HP Fax page 2
DESIGN ERANGINEER: 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: iNot 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,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
for the first'nspection. If you intend to obtain financin consult with lender or an attorney before
m ncin rk or recording our Notice of CommenWnent. fl
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ignatu a of Owne LesseelContractor as Agent for Owner ignature o Contractor License Holder
STATE OF FLORIDA —� + ) STATE OF FLORIDA
COUNTY OF 1441 COUNTY OF
The r oing in turn nt was acknowledge before before me The for Ing Inst' ment was acknowledged before me
is day a �.� ^, 2tl L�by ihi day of 20 by
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Na a of person ackn ledgi } {Name of person ackn dging)
Sig ature of Notar u lic-State of Florida} { JAM&of Nota u Itc- ate of Florida)
Personally Known V, OR Produced Identification Personally Known OR Produced Identification
Type of identification Produced Type of ldentific produced
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Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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IN1TlALS