Loading...
HomeMy WebLinkAboutBuilding Permit Application . I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE CCEPTED Q 1 Date: ermit Number: i z- RECEM - _ Building Perm t Application JUL TO 2018 Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie County 2300 Virginia Avenue,Fort Pierce FL 34982 Ihone- (772);462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED 1'NPROVE10V ENT LOCATVIRNS Address: Legal Description: Property Tax ID#: Lot No. Site Plan Name: Block No. PrIoject Name. Setbacks -Front Back: Right Side: Left Side: D T FLED [3E-��R+I�PTION QF W©R�K: i I COIUSTRUC IO ('NFO 11JIATIO Additional work to be pertormed under this permit—c ec all that pp y: . _Mechanical _Gas'Tank _Gas Piping Shutters Windows/Doors Electric _Plumbing _Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction:L, �l Sq. Ft. o First Floor: Cost of Construction:$__ 1,J 0-y Utilities: _Sewer _Septic Building Height: O N�ERj ES�SEE• CONTRA OR: 'Name Name: !Address: , Company: City: 'G �e State:Ff Addres Zip Code: Fax: City: State: Phone:,No.77� o'1 `��' Zip Co e: Fax: E-Mail: Phone qo Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed,above) State o County License If value of construction is 2500 or more,a RECORDED Notice of Commenc ament is required. SU1 'PL =,MEN L CON5TR C1"ION I LIEN LAW FNFOR+MATIaN: 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 o r Notice of Commencement. Signature oY Owner/L ssee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFa ; COUNTY OF The r oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of - 20&'Z by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced ign ure of Notary P 6 ricla_ (Signature of Notary Public-State of Florida) LASHAHNA INGRAM ��tP Big Commission No. Nota(S(F- l)lic-State of Florida Commission No. (Seal) My Comm.'Expires Dec 20,2018 Commissicn y'l FF 177249 Bmrc+ or.a"!otary Assn. REVIEWS FRONT ZONINd SUPERVISOR� PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ' COMPLETED �_e_v_. 8/2/17