HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �j y
Date: Permit Number:
` I RECEIVED
_ Building Permit Applicat on APR 3. 7 ^egg
Planning and Development Services ST. Lucie County, Permlttlng
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: 'S
PROPOSED bMPR01/EME I LOC NO 4 :ffl
dress: � r
:P or perty Tax ID#: I a e!> I - -- 41 i V C3 CA Lot No.7 _
Site Plan Name: Block No.
Project Name:
DETAILED DMCRI'PTION OF WOR+K:
0'e-iUT" s�
CONSTR!UCTIO Ng I I 1 FIX R,MATI ON:
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
G dotal Sq. Ft of Construction: c9 i 10 L p Sq. Ft. of First Floor:
-Cost of Construction: $ p,r) 0 Utilities: _Sewer _Septic Building Height:
OWNER/LE�SSfE: CONTRACTOR:
I r V
Name iix� iQ, Name:
Address: (,:, 3 v& S' )) Company:
City: Ji- , RAh l State::, Address:
Zip Code: Fax: City: State:
Phone No. Cz-"c3 Zip Code: Fax:
E-Mail: _6(_ Phone No
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.
SU}' CEMENT CC}NST CTIQN L IEN LAIN 111ll
`yaRM�►TiCJN.•
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.conflictwith any applicable Home Owners Association rules, bylaws-&'and covenants that may restrict-or.prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictionswhicli may apply.
In 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 AkATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.."
Sig ature of 0 e /i[1sseeTC"6n_t'rTttdr as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY COUNTY OF
OF S-�, Z L1c i2
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge before me this day of 20_ by
this N\ day of 4 I 20, by
0 ,11 -Y\ Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification Type of Identification Produced _
Type of Identifica ion
Produced N
(Signature of Notary Public-State of Florida)
(Signature of Notary PubNJL State of�' � 1 Commission No. Seal
p NANIARIEGINI
°,<, ISSION#GG 0?2023 �s
Commission No.�{sd my �! 11
16,2000
e ti? EXPIRES.DecePu Underwiters
•o, d7hN Notary Public
Bonde
REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19