HomeMy WebLinkAboutBuilding Permit Application ALL AP
• MUST BE COMPLETED •• APPLICATION TO BE ACCEPTED
Number:Dat Permit + 3 `
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PermitBuilding Application
Planning and DevelopmEnt
BuildIng r ■ Code Regulation DIWslon
/1 Virginia Avenue,Fort Pierce FL,34982
Phone: 462-1553 Commercial Residential
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Additional worK to be performed under this permit—c
apply.,
0HVA Gas Tank F]Gas Piping Shutters ElWIndows/Doors
0 Elearic Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction, S Ft of First Floor-
Cost of Construction:$ "t —Septic Building Height:
Utilities. Sewer El
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SEP-27-2017 WED 09:82 AM CENTRAL SCHEDULING FAX No, 3212686138 P- 003
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: __Phone-.-
FEE
hone:FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name' Name:
Address:_.- Address:
-
City: City.
--- _. _........-----
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application 1s 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 Count makes no representation that is granting a ppermit will authorize the permit holder to build the subject strupture
which is In conflict with any applicable Home owners Assocfeon 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 1 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-residentlal 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 recording our Notice of Commencement.
=11DA
r/Lessee/Contractor as Agent for Owner Sigr ofnatuontractor/License Holder
�1�� + I ,�• SPATE OF FLORIDA
COUNTY OF V3 � l /1 ,� COUNTY OF
The f r oing instrumen was acknowledged before me The f r oing ins a was acknowledged before me
t ' day of 20��by this day of 11, 20J:2 by
Name of pers making statement Name of persgn making statement
Personally Known OR Produced Identification Personally Known R OR produced Identification. ._
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public- ra Flor��t�herine Tion ep
(Signature-of Notary Public-State FI rids)
• 'C g Catharine Konge>~
Commission N -• un�lRF17z372 Commission No. .'_CWMYon#FF1.72371
�:0C('Z8,2018 `,'• Expires:M 28,2018
DONDEDTHM ..�' BONDED[I{AU
n„u+ IST PIAAIDA NOMY LLC �•.,i„a" IST YLQAiDA NOTAE Y LLC
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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