HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
Permit Number: Z6y) — G Yy I
Building Permit Application
Commercial Residential
RECENED
JAN 21 2020
Permitting Department
St. Lucle County
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Property Tax ID #: bix> � n Lot No.
Site Plan Name: Block No.
Project Name:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters.
_ Electric _ Plumbing C _ Sprinklers _ Generator
Ft of Construction: 0 d
�n �tiet 3S 2y
Sq. Ft. of First Floor:
Windows/Doors
Roof :` Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE-:
GONTRAC-TOR:
Name
Name:
Addres :
r7(9
Company:.
City:
Statef^ C
Address;
City:-' IJ State:_
Zip Code: $`Z Fax:
Phone No.
Zip Code: Fax:
Phone No F'
E-Mail:�� C L .
Fill in fee simple�i e H ler on next page (if different
E-Mail
State or Qounty License
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in Home Owners Association bylaws that
conflict with any applicable rules, or and covenants 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:"
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SEENALGOSTRUCTIOLAIIO:
DESIGNER/ENGINEER:_NotApplicable
Name:
MORTGAGE COMPANY:Not
Name:
Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip:Phone:
State:
FEE SIMPLE TITLE HOLDER:Not
Name:
Applicable
BONDING COMPANY:
Name:
_NotApplicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
re of Owner/ Lessee/Contractor asAgent for Owner
Signature ofContractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SL G.t4�'f
COUNTY OF
Theforgoing instrumentwasacknowledged before
me
The forgoing instrument was acknowledged before me
this 2[.day of�✓20�vby
this_day of20_by
Nameofperson making statement.
Name of person making statement.
Personally Known OR ProducedIdentificationsPersonally
Known ORProduced Identification
Typeof IdentificationTypeofIdentification.-
,ProducedProduced
Pulito of FloridaSignature
of Nota