HomeMy WebLinkAboutBuilding Permit Application All APPtiC'ABLE INFO MUST BEs"COMPLETED'FO APPLICATION TO BE ACCEPTEQ
I+ VED
JUL. i2 2019
Building.Permit Applic 'on
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Rlhnnng'and'DeJt'lopment 5enices 9 4 e p a rtm e n t
Building:and Code,Regulation Divislon -: L U C I e,CO U n ty� FL
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Phone:=77.2 :462-1553 -Fax-`(7-72)A62-l5!&"-2
2300 Vir cora Avenue,FortPierce_FL 14
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PERMIT1631,
TYP;Ea,
i Address::
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Lot No
Pro ert Tax ID:#•
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Site Planl:Name:, ., Block No.,
Project Name
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Aldlti al work;to be,performed under this."permit;—check all that apply:. :
"Mechan►cal Gas Tank Gas:Pi 1n -• �5hutters Wmdor+Vs/Doors
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Electric, _ . PI .
_ umbing, _Sohn Iprs Generator Raof: Pitch.
' Total 5 �Ft of:Constr_uct _. .- Sq Ft;of First,Floor:
Costof`6ristruchon $.
Utilities : =Sewer, SepU6 Build ngsHeight
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Compan
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Zip Gode:. inFax`
Phone No ._ ;- ;: Ztp Code F'z
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:Fill in fee simple Title Holder,on next page,(If different E-Ma' --
t "frorrr the Owner listed above)' ;;Sfate:or County:License ,
. ;If.valueof consfruction is$�SOO:or more;-a RECOROEQ Notice of CommencemeMilt required:
ifwalue of HVAC i5$?',500 or more,a RECORDED f+totie of Commencment is required:-.,
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:. , Not-Applicable;
Name: Name:
Address: Address: -
City: State:. City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER,: _Not Applicable' BONDING COMPANY: Not Applicable
Name:: Name,
-
Address: Address:
City: City:_
Zip; Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby`made to obtain a permit to do the workand install'atibmas indicated.
i.certi_fythat-nowork or installation has commenced prior to the:issuance of a permit.
St.Lucie Counttyy makes no representation that isgranting a permit will authorize'the permit holderto build the subject structure
which is in confli'ctwith any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association'and review your deed.for any restrictions which maya.pply.
In consideration of.the granting of this requested:permit,I do hereby agree that,l will,in a.li.respects;perform the work'
in accordance-with thapproved plans,the Florida Building..Codes and St.Lucie County Amendments.
The following building permit applications-are exempt fromundergoing a.full concurrency'review:-room additions,
accessory,structures;,swimming pools;fences,walls,signs,screen rooms and accessory uses to:a`nother non-residential,use
"WARNING TO QrNER: YOUR FAILURE;_TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT`IN YOUR PAYING.
TWICE FOR IMPROVEMENT$,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 NOTICE OF COMMENCEMENT."
Sign e'of ner/Lessee.Contractor as Agent#or Owner " gna of`Contractoease Holder
STATE OF FLORIDA STATE OF FLORIDA j—
COUNTY OF C./` �'�r _ COUNTY OF L�9
The oin .ins - acknowled fore me The oin instru t s cknowled efore me
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this d -y o_ ,20 y this ay,of 20r by
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Name of person,rriakin statement:- .. Name o person ma in statement.
Personally Known• QR-Produced.ldentification Personally Known -OR Produced Identification
Type of Identification Type of Identification
Produced Produce _
' ture of'Notary,Pub at a CRYSTAL MAI Notary`Pubfic ot $TAL
qa My'COMMISSf N#FF90217 ;•_My COMMISSION#FF.
Commission N S June
EXPIRES J rhs�8,rE6I n'
(407)388 0153 Fiorldaldo4e S�rviea.eorn A07)398-0153
REVIEWS FRONT ZONING SUPERVISOR .' PLANS VEGETATION SEA.T.URTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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DATE
RECEIVED
PATE _.
COMPLETED
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