HomeMy WebLinkAboutBuilding Permit applicationOWNER 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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contllct 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 INTEND TO OBTAIN FINANCING, CONSULT
.. ..r .nnnury ncrnnr nrrnnnaNa YOrJR NOTICE OF COMMENCEMENT."
of er/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF 5i'� Z2 O
The fo ing instru t was acknowledged1 efore me
thisdayof�2Q�,
by
6.
rias be 1
Name of person king stat ment.
Personally Known OR Produced Identification
Type of Identification
commission NdJ`/�/�
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Notary Public • Su
Commission p C
ay Comm, Eaplres
d through Nations
SUPERVISOR
REVIEW
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20__ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
IJ of Notary Public- state of Florida )
341(Seal)
iclin No.
rota
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
]IMPON Lfl Nl 6,A ..I , 0,191 �i?IC1N,
'
DESIGNER/ENGINEER,
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Nai14
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address: d
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contllct 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 INTEND TO OBTAIN FINANCING, CONSULT
.. ..r .nnnury ncrnnr nrrnnnaNa YOrJR NOTICE OF COMMENCEMENT."
of er/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF 5i'� Z2 O
The fo ing instru t was acknowledged1 efore me
thisdayof�2Q�,
by
6.
rias be 1
Name of person king stat ment.
Personally Known OR Produced Identification
Type of Identification
commission NdJ`/�/�
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Notary Public • Su
Commission p C
ay Comm, Eaplres
d through Nations
SUPERVISOR
REVIEW
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20__ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
IJ of Notary Public- state of Florida )
341(Seal)
iclin No.
rota
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: e'S 00�—y 1L`ay
i
if value of construction is $2500 or more, a Ktevrcueu Mot Ce . .................. .
If value of Hvac Is 0,00 or more, 2 RECORDED Notice of Commencement is required,
Building Permit Appli ation N'.w ` 2020
Planning and Development Services i t E
Building Code Regulation Division
and
-
1300 Virginia Avenue, Fort Pierce FL 34981.
Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 _
PERMIT TYPE:
tM1F�ftGJ�Vtl1-M 'NT AI 1"OIC:
7
Address / / V �� �✓ � f� 4 13 z T if I 0 U
%�/ �� — 7 70 000 — 7 Lot No.�'I _
Property Tax ID #:
Block No.
Site Plan Name:
Project Name:
�Nsr,�// g y SNSy ✓u V£
Oe AJ
-71
Additional work to be performed under this permit—check all that apply:
_Gas Tank _Gas Piping _Shutters —Windows/Doors
_Mechanical
_ Electric _ Plumbing _Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction:[) l� Sq. Ft. of First Floor:
Cost of Construction: $ /O 0 D Utilities: _Sewer _Septic Building Height:
O�/11G_° , .
1
CONTRACTOR:
Name r RL G 7V'505C 1 /
Name:
Company:
Address:_ _
State:—
Address: 11 7 v C c. -,f L /r Z A QcTN L••aT"
City: Fo,e f Pis✓c State: _
Zip Code: 3 r7' f `+' f Fax:
Cit V:
Phone No. 5-41/ 460-2 �Q s(o
Zip Code: Fax:
E -Mail: 9 Rtes C_IZA Z- Y 9 E AQ ea'"1
Phone No
E -Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
_s
r........•..rnmwnt is required.
if value of construction is $2500 or more, a Ktevrcueu Mot Ce . .................. .
If value of Hvac Is 0,00 or more, 2 RECORDED Notice of Commencement is required,