HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
COUNTY
1: 1 n R 1 C
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMIT TYPE: VVI C_
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential
Address:1 `,��Y' Yl�
Property Tax ID#: 12cw1 ����"v�►--1� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
cry
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
*�Iechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ L4
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L t i k i i I
Name: J
Company:.
Address:
City: pna ��C� State(j
A d d r e s:c N
Zip Code: Fax:
City: State: vcl
Phone No.
Zip Code: Fax: II ,^
PhoneNo �- � "' LD_� L4Le
E -Mail:
Fill in fee simple Title Holder on next page ( if different
E -Mail S
from the Owner listed above)
State or County Licen
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is requlrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not App
State
Not Applicable
INF_ -
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:.
I certify that no work or installation has commenced prior to the issuance of a permit.
te:
Not Applicable
St. Lucie County makes no representation that is granting a permit will authorize thepermit 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 your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
-5`5gr�ature of Contractor Holder
STATE OF FL I A STATE OF FL¢tIDA
COUNTY OF��"� �_ COUNTY OFC '>���r`�C1�Y-�
They rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisrJ(, of a , 20\C�by thia�,day of(�Y i�l 20 � by
i
(Name of person acknowledging) (Name of person acknowledging )
ure of Notary Pu ic- Stat4e of ITorida) (Signa r of Notary Pu is ate of Florida )
Personally Known OR Produced Identification
Type of Identificatio Produced
Commission No.i(z 1� �� C-1
Revised 07/15/2014
Personally Known� OR Produced Identification
Type of Identification Produced
CYNTHIA rhKW N
MY COMMIS ION rY FF961289
CYNTHIA CLAY MCNABB
MY COMMISSION r FEW I214E
EXPIRES April 12, 2020
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