HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE w%L MPLETED FOR APPLICATION TO BE ACCE.=r,d
Date:
Permit Number: III Ia-' M 9!
RECEIVED
Building Permit Application DEC13 7019
Planning and Development Services Permitting Department
Building and Code Regulation Division st. Lucie county
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
Q a A FV & -r2Ee 02
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Project Name:
-f iwq "fO 6P5rNJ Cd-
To (; -i Ut 2
Lot No.
Block No.
ISM% AG r'-QC#-nbA) 0` 6:Xl57fNCG M4,57-61L
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
,�T.otalySq. Ft�of Constructr_o�: �2 Sq. Ft. of First Floor:
.Co'stofGonstructiott$^, 000- Utilities: _Sewer _Septic
Address: E;�9l ri P11\J6171 & D2 _
City: FT_ /2Qt/Z.Gt State:fL
Zip Code: 34 Q$ 2 Fax:
hone No. q-6 I ZS/ 9 6
1 -r3-
-Mail: L7PY-O O-d . inede to ,F,O/ ,
Coln-
Frill in fee simple Title Holder on next page ( if different
listed above)
Name:
Windows/Doors
Roof Pitch
Building Height:
Company:
Add
City c ,:
State:_
Zip Code':
State or County
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.
Not
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: '
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone:
BONDING COMPANY:
Address:
Zip: Phone:
_Not Applicable
OWNER/ CONTRACTOR AFFIDAVIT: 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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _�13day of Q_te— 20 1Qby
this _ day of 20_ by
.,Upnmrn� L('Choon.
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifica ' n
`,J+-
Type of Identification
Produced
Produced
Iftnathre of Notary Public- tate of Florida)
(Signature of Notary Public- State of Florida )
Commission No.
Commission No. (Seal)
MYCOMMISSIOUNG13275M
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REVIEWS
FVUN I
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PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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