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HomeMy WebLinkAboutWinfieldpermitappALL APPTIC FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED lt Date:Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (7721 452-1553 Fax: (772) 462-7578 Commercial Residential X Site Plan Name:Block No. Project Name: Setbacks Front Back:Right Side:Left Side: PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Property Tax lD #: 16,rr \L6eee*\.[f\' Y \otu* \\eor $u1ury appry: Ehuo. I-lr,"o,.,. Total Sq. Ft of Gas Tank Plumbing Shutters Generator n *,noo*s/Doors tr nsprinkters tr Roof pitch Cost of Construction: S So. Ft. of First Floor: Utilities: l_l r"*", E t"r,' lf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. City: 111'fl- Vl UYt43 State: Zip Code:{}-lt'l-J I Fax: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) city: ktYtSCt' (ff LUL, a' Zip code: tl4qt \,d2 F-ai: Phone *"ITJZ- t*1}Emu e-vrair:cx{Y\e€r {tk&cmfil\ csfn \,, State or County License: 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 Countv makes no reoresentation that is srantins a oermit will authorize the oermit holder to build the subiect structure which is in conflict with anv a'oolicable Home Owfiers Asiociation rules. bvlaws or and covenants that mav restrict or prohibit such structure. Please consult with liour Home Owners Association and review'your deed for any restrictions vihich may apply. ln consideration of thegrantingof this requested permit, ldo herebyagreethat lwill, in all respects, performthework in accordance with the approved plans, the Florida Building Codes and 5t, 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. lf you intend to obtain financing, consult with lender or an attorney before work or reco ur Notice of Commencement. Rev.8/211-7 Signature of STATE OF Lessee/Contractor as Agent for Owner couNw oF The this day of (Signature of Notary Public-tEgtherine lionger FF172372 Type of ldentification Produced (Signature of Notary Public- Catherine lbnger iC@uitlion#FF17?J,n :Expires: OCI 28,2018 BONDED THRU 1ST FLORIDA NOTARYII.C STATE OF The fo-going ins this 3 day of Name of per5on making statement Personally Known A* OR Produced ldentification SEA TURTLE REVIEW DATE RECEIVED