HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Commercial i Residential
PERMIT TYPE: --BL-3 't I A I"r'�q ,- . kct-r—.P M C n +-
ROPOSED MPROVEMENT LgC1 X 111:
Address: DES Ocfcm Dr -
Property
Tax ID #: ti 2�3- i - 2- • t LiD -i Lot No.
Site Plan Name: CE+ (-L-)(-ie, co -1- 1Y 1-• f + p *= E
Block No.
Project Name:
DETAILED DESCRIPTION O.F ORK �
CO N STRL
RMATION.
Additional work to be performed under this hermit -check all that apply:
Mechanical _ Gas Tank Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: �j
Cast of Construction: $ � l � i c) _ C -r-3
OWNFR/LESSE .
Sq. Ft. of First Floor:
Utilities: _Seaver _Septic Building Height:
NameLL- k { .if
erc1Y_.
Address: � L�� �'�' +"� I• � [l�lr 1�
City: A- . State: AFL
Zip Code: 3LU�IS1) Fax:
Perone No.
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
CONTRACTOR
llvame:L- LI
`Cora pa ny: =�AV2
Address: :z'(go.2. K 05 tiN)S j
City: State: -Q-
Zip Code: op2� 2-m Fax: 32i-33$- 4CS
Phone Na -?D2 C�'I 2's
E-MaiI alis
State or County License
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNEE:/ENGINEER: Not Applicable MORTGAGE COMPANY: Nat Applicable
Name: Name:
Address: Address:
I City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
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-
` 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 JOS SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO 013TAIN 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 FLOA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The or ing instrument was acknowlecl ed before me :.
I this day of 20_ by this of 2QXDby
Name of person making statement. Name of person making statement_
I
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced
j
Produced
I
E
�
Jk
{Signature of Notary Public- State of Florida } (ignatu e of Notary P lic- State of Flori a )
Commission No. (Seal) Commission No.
_ NICO E SANCHEZ
Notary Public - Stale of Florida
Comm.CommExp�res Mar 5, 2023
REVIEWS FRONT ZONING I SUPERVISOR PLANS VEGETATI S�l�l3�LgENati�+,�YIAtNC �O
COUNTER REVIEW REVIEW REVIEW REVIEW I
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DATE-
RECEIVED
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DATE - —
COMPLETED Ij
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