Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '7• v2�/• _ Permit Number:R E "'CE."VED .. � : . ._ BuildingPermit App I catio nA 2019 Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie CSentyf FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 . Commercial Residential PERMIT APPLICATION FOR: . PROPOSED INP OUEMENT' t©CATI'0 Address: Legal Description: �oL Lc) 4 is Property Tax ID#: Lot No. 6 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAI{_ED DESCRIPTION C+F ®RFK. C0 S R CTfO i NF86R,I MAIR IN 4 Additional.Wqrk�to,pe pe Orme un er this permit—c ,ec Va t;at ap'p y: 41 �� _Meclan.ical _Gas Tank _Gas Piping , 4; _ i _t,,Shutters _Windows/Doors vi `Electric; Plumbing _Sprinklers 7 ?Generator Roof Pitch Totaf'%."I't of-Construction: V110 q.Ft.of;,F rst Floor: b Cost of Construction: Utilities." `_56' er Septic Building Height: OWN'ERJL1-17111E: CONT RACTQ.R. Name ' (ZIP Name: Address: 5 Vt Company: City: State:'' Address: C Zip Code: Fax: City: State:s7]—n' Phone No. 15 C1 Zip Code: _L Fax: E-Mail: Phone No <rlq Fill in fee simple itle Holder on next page(if different E-Mail �C� r�G����A WV'L' from the Owner listed above) State or County License cZq- L�­7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPP'LI MA,ENTgC CANS R?UCTI4N LliN LAW I' FD ';IUIgT10 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 po.ols,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 our Notice of Commencement. Signature of Owne /Lessee/Contractor as Agent for Signature of Contractor/License Holder _V.,'',•'' STATE OF FLORI T`+y5� t' : STATE OF FLORIDA °. COUNTY OF COUNTY OF a Theor oing instru ent was knowledged before The fo ng instrument was acknowledged befo a th day of 20_ by c this; day of Of by fn o co Name of person making statement. . . = Name of person making statement. Gi Personally Known OR Produced Identificati Personally Known OR Produced Identific n Type of Identification Type of Identification Produced ; Produced a"Ae4'6�Z t0k� (Signature of Nota Public-State of Florida) (Signature of Notary blic-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17