HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Permit Number:
Date: --
f .K_.._i._ ;�=_ RECEIVEfD
- -� - Building Permit Applica ion SEPI 0 ^Jig
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCAT N:
Address: —7 ss0c_
Property Tax ID#: 3 T/`1" 5�� J IOP" 3 J 6 D Lot No.�
Site Plan Name: Block No.
Project Name: X11.
DETAILED DESCRIPTION OF WORK:
Pun 1V
i 1
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
Mechanical —Gas Tank _Gas Piping _Shutters WindoDoors
_Electric _Plumbing —Sprinklers _Generator Roof Vl"_�Pltch
Total Sq.Ftof Construction: ;Z a dy ��� Sq.Ft.of First Floor:
Cost of Construction:$ �Q��. Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name V S Oi/V e Name: -shar4ene �P
Address: `7SS'0 ShernS -7-,A'—L— Company: -Pa
City: Mb r-c f Vc- State:T 'Add r*s:-? L/� Uzaey L if
Zlp Code:_ S x: cityneyA , State:
Phone No. -7 -2)/ Zip Code: Fax:
E-Mail: !/fi r J,A tit° (!0 -� Phone No
Fill in fee simple Title Holder on next page(if different E-Mail , Io CDr
from the Owner listed above) State or County License MC 13-':� A &S-9.
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAWIN
DESIGNER/ENGINEER: _Not Applicable RTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: St City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:� Not Applicable BONDING COMPANY- Not Applicable
Name: Name:
Address: / Address:
City: City:
Zip: hone: Zip: Phone:
OWNER/CO RACTOR 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 fNMD TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU OTI E OF COMMENCEM "
'J�"f�241 0
Signature of Owner/Lessee/Contractor as Agent for OWnle Signature of Contractor scene Holder
STATE OF FLORIDA STATE OF FLORIQA
COUNTY OF cls COUNTY OF S liy c i
The for oing instr e as acknowledged before me The forgoing instru gnt was acknowledg d before me
this day of 20 1°1 by this day of 20LS by
Name of person making statement. Name of person making statement.
Personally Known Produced Identification Personally KnowOR Produced Identification
Type of Identification Type of idents cation
Produced Produced
(Sig ature of Nota I - t t ri (Si nature of Nota -
�fr"r No Public State ol•Flwlde Notary.public Stet®of FlOrlda n.
Commission No. 1.'p KelICamierl r2afi GCS 240679 Commission No. 'A .il y mi 240679
"i'4 q Expires o7 4w2 22
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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