HomeMy WebLinkAboutBuidling PermitAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit APPlication
Plonning ond Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
propertyraxrD *, BAI-(:/l -Ot// -O)C^f 6
Lot No, /
,rorO*o/4-Site Plan Name:
Project Name:
Additional work to be performed under this permit - check all that apply:
_Mechanical
Electric
_ Gas Tank
Plumbing
_ Gas Piping
_ Sprinklers
Shutters Windows/Doors
-
Generator
-
Roof -- Pitch
TotalSq. Ft of Construction:Sq. Ft. of First Floor:
Cost of Construction: S Utilities:
-
Sewer
-
Septic Building Height:
PERMIT TYPE:
Company:
Address:
Zip Code:
E-Mail
State or CountY License
Zip Code:
Phone No. /72-JlA -i<-/ /
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
lf t "l,* "f .""tt-ction is S25OO or rnore, a RECORDED Notice of Commencement is required.
lf value of HVAC is S7,5OO or more, a RECORDED Notice of Commencement is required'
SU PPLEM E NTAL CONSTRUCTION LI EN LAW I N FORMATION :
LK/LNG|NEER: _ Not Applicable
Name:
Address:
City:State:
zip:Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:State:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip:Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
zip:
OWNER/ CONTMCTOR 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.
5t- LYcieCounty.makes no representatign thaLis granting a permit will authorize the permit holder to build the subiect structurewnlcn ls ln conlllct wlth any applicable Home Owners Association rules, bylaws or and covenants that mav restrict <jr prohibit suchstructure. please consult with''yiour Home owners Associat'roh and ievi6w'yoti deed foi any i;;lri';iid;;iJt1i;h';ir';y;fpi"y.""'"
ln consid.eration 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 I{OTICE OF COiIMETU€EMENT MAY RESULT IN YOUR PAYING
TWICE FOR IiIPROYEiIEIUTS TO YOUR PROPERTY. A NOTICE OF COMMENCEiIEITT iIUST BE RECORDED AilD
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. tF YOU TNTEND TO OBTAI{ FlNANClilc, COilSULT
WTTH LENDER OR AN A RECORDIITG NOTrcE OF COMiIEilCEiIETT.'
a-s Agent for Owner
STATE OF FLORIDA
/'
Personally Known / OR Produced ldentification
Type of ldentification
Produced
In: f [-r' ]f "uq?Y" " o n o*' ":E1W' " ^ "
Name of person making statement.
Personally Known _ OR Produced ldentification
Type of ldentification
The {pgoi ng i n st ru4erlt was acknowledgefl }efore me
this Y" dav of Ltl)'t .zoL9bv
of person making statemen
'' ,&. '-i.-. lt,ty col,ttttrssrci,{ ',{ffilp(le17
ES: i,tarti e .:ozg
[.1Y COMlt4tSStON # GG 300817
v5.J'r::1. .'rtt:*'t+l
DATE
COMPLETED