HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Cp• �_�� , �' Permit Number: f?V zo
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Building Permit Applica ion JUN N I
EC!!VE
2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. LUCIe OUnt PI_
2300 Virginia Avenue,Fort Pierce FL 34982 y
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resl en la
PERMIT APPLICATION FOR:
PWINNERS,ED IIPWUEMENI LOCATION:
Address: s (�; �� �S i�Q.,.�. cx9��
Legal Description:
Property Tax ID#: �j��d - 5G�- 2-�«— 0 cje'l Lot No.
Site Plan Name: Block No.
Project Name: VSs
Setbacks Front Back: Right Side: Left Side:
DETAILED D'E�5CRIPTION OF WORK:
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C0 STRUCTION INFORMATION:
itional work to be performed unclert is permit-check all tat appy:
_Mechanical _Gas Tank _Gas Piping _Shutters VWindows/Doors
_Electric _Plumbing _Sprinklers . _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ ® d (% Utilities: —Sewer —Septic Building Height:
WE CONTRA11-001
Name CESS Name:
Address: SSU G�����5\�oti� _ Company:
City: State:- Address:
Zip Code: Fax: City: State:
Phone No. -1-7?- `�g2�� 2�`( Zip Code: Fax:
E-Mail: 11C) �\ oes c o y Phone No
Fill in fee simple Ti a Holder on next page( if different E-Mail
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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SUPPLEMENTAL CONSTRUCTION LIEN LAW I'Nt'ORMATiC}N:
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:
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 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,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 work or recording our Notice of Commencement.
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Signature of Owher/Les e/Contractor as Agent fo Signature of Contractor/License.Holder
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STATE OF FLORID _ w STATE OF FLORIDA
COUNTY OF ¢LL - COUNTY'OF
The f oing instr ent was acknowledged before A The forgoing instrument was acknowledged before me
this day o ,20by ww this day of 20_ by
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Name of persoh making statement. Name of person making statement.
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Personally Known- OR Produced Identificati = :0. Personally Known OR Produced Identification
Type of Iden6icatio °;;*;;�' Type of Identification
Produced Produced
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( ignature of Notary Public-State of Florida) U (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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