HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: $ `VN Permit Number:
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:
Lon
EIVED
Building Permit Applicat0 S �I)i9
unty, Permitting
Commercial Residential
1'PROPOSED IMPROVEMENT LOCATION: I
Address:
Property Tax ID#: 3700-- A0-5-000-0DO-'gJ Lot No. /7-fj3
Site Plan Name: r' wl-_ Block No. 9
Project Name: Jag5M brut.
DETAILED DESCRIPTION OF'WORk: '
• • •' NTIOV.
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �yC�O.Ov Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:-
Name 7-
blief
Name:
Address: ?/L) AX IA -Ai Viz,
Company:
City: 7; /&t- RWLy State:4L
Zip Code: 3fez Fax:
Phone No. =- 372 -SSbZ
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: XhAy CL;FZ( , 6019A 1CVi`1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
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.
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 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 YO R LEN R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ev.
SURPLEMENTALCONSTRUCTIONyLIEN=LAW.INFORIVlATION: `
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
[Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signatur of Owner/ Lessee/Contractor as or Owner
Signature of Contractor/License Holder
STATE OF FLOP Dq c
STATE OF FLORIDA
COUNTY OF . L.tJCa�
COUNTY OF
The forgoing inst ent w s acknowledge{ before me
�S day by
The forgoing instrument was acknowledged before me
this of 20L
this _day of 20_ by
Name of person making stateme t.
Name of person making statement.
�
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
,Q�—rILfLP O_o mil_,
Produced
(Signature
�
(i nature of Notary'Public- S��y�f FloridQ����INEC
(Signature of Notary Public- State of Florida )
�••••, n`
�SSION#GG 033730
Commission No.
Commission No. (Seal)
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SUPERVISOR
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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RECEIVED
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DATE
COMPLETED