HomeMy WebLinkAboutBuilding Permit Application-------------
01/06/2011 02:13 l ENILIA PAGE 02/06
All APPLICABLE INFO MUST HIE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
I Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue,Mrt Pierce FL 34-982 L.Z
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
Site Plan Name: Block No. IQ
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Additional work to be performed under this permit–check all that apply:
Mechanical GasTank Gas Piping —Shutters Window5/Doors
Electric Plumbing Sprinklers —Generator Roof Pitch
Total Scl,Ft of Construction: /�� Sq.Ft.of First Floor:
Cost of Construction:$ 0 Utilities: —Sewer _S eptic Building Height:
Address: c?,5-3,7 CQoIc-77, Company;
Zip Code: TIZ Fax: City: State:
Phone No. lip Code; Fax:
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$1,500 or more,a RECORDED Notice of Commencement is required.
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01/06/2011 02:13 1 ENILIA PAGE 05/06
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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 SiMP TITLE HOLD W —Not Applicable BONDING COMPANY: Not Applicable
Name: /l4 Name:
Addr �� Address:
City: L City:
Zip: f Phone.• S' Zip: Phone:
OWNER/CONTRACTOR AFFIDVrf: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,1 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 OWNEW YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TwK E FOR IMPRorEME us TO YOUR PROPERTY. A NOTICE~ OF COIiAMENCEMENT um BE RECORDED AND
POSTED ON THE ,JOB SiTE BEFORE THE FIRST INSPECTION- W YOU ENYE111D TO ORTAW FWANCING, CONSULT
MTJW YOUR LFADFR OR ATTORNEY CORDING YOUR NOTICE OF COMMEINCEMENT.-
Sign ure of OwnWI L ee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO ID STATE OF FLORIDA
COUNTY OF_70 Zv c,!� COUNTY OF
The foToing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of fl:-. 201V by this day of .20_ by
Name of perso statement. Name of person making statement.
Perso y own R Pr cod Identification Personally Known __OR Produced Identification
Type f Ide tificat! Type of identification
Pro uced ! Produced_
l
(Sign f Notary Pub Ic-S t (Signature of Notary public-State of Florida)
SAVDRA M.ROMA
Commission No.. @ OMMIssloi4aGG15392 mmission No. (Seal)
kXPIfZE9.January 03,202
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.217/19