Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2J ? I q Permit Number:_ - 19 w= r RECEIVED Building Permit Applicatioill Planning and Development Services FEB 2 0 2019 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting Phone: (772)462-1553 Fax: (772)4624578 Commercial �Residential PERMITTYPE: A k� PR C�3E' IMPAR .1C iUf CATI Address: hy Property Tax ID#: ,/ A ON DO 0 016 0D Lot No. Site Plan Name: Block No. Project Name: DETIf�LED U=�SC:S�P 1'ON Oi�d� f�RK� C©Y TR_ CTION NfQft ` ` flN; . Additional work to be performed under this permit–check all that apply: —Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors ✓Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �U' Utilities: _Sewer _Septic Building Height: Name r�� kv)-,I Name: Address: Company: City: State: Address: Zip Code: Fax: City: State: Phone No. Zip Code:,3Gj Fax: E-Mail: Phone Noa �Jc7�i 03 Fill in fee simple Title 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. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. S PA 10M7, GQNST UCTI©N LI NLA INFbRMATlO 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N TI CO ENT." Sign ture oT Owner essee/Contractor as Agent for Owner Signature of ontrac or/L'cense Holder STATE OF FLORI STATE OF FLORID COUNTY OF COUNTY OF The f r oing instru nt was acknowledge before me The for oing instrurr r was acknowledge efore me this, day of 20,fA by this Zday of � l�Qi 2011 by -Vv-&qj it Z ag�L Name of person making state ent. Name of person making state ent. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifikation Type of Identificatr Produced Produced t • 1 _ c ;. �1 (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Commission No. Commission �'`��a"����'�. KAREN S. NI KAEE . LSEN e o FloridaState oary Public =: ,,207484 r Cammission #GG 207481qy Expires °Rn , inmission Ex°jn �`REVIEWS F N'P _ZQ R PLANS June ' pi eS GROVE �II0 CO REVIEW REVIEW REVIEW REVIEW VIEW DATE RECEIVED DATE COMPLETED eV.