HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE
Date: (1.- 1.3 - 14
FOR APPLICATION TO BE ACCEPTED
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Address:OCota,4 A J A
Property Tax ID #;yyoi-s
:-
Site Plan Name. illi VA 6.
Project Name:
ar
WA714
Permit Number: 1 rA k a -(3 a,J1
Building Permit Applicati n ®EC 1 3 ?p,g
ST. Lucie County, permitting
Commercial Residential
cr►Y F/,.3Y9g0
Lot No.
Block No.
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Additional work to be perfor d �y/IdeFte�s per ' - check all that apply:
Wvr i
_Mechanical _ Gas Tank Gas Piping _Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ oa
00
Sq. Ft. of First
Utilities: _ Sewer _ Septic Building Haight -
Name t .....:...
TON
Name:
Company:
Address: .S[J AA02 ,-f4 Lt/
CnY'rN State:
Zip Code: 3 O Fax:
Phone No
F
Address:A2=If • L.I VA L 4967W,
City: PAL/ Cifl( State: _
Zip Code: 3_ 4990� Fax:
Phone No. 553°
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail V l aQ1�
Cpp�
from the Owner listed above)
State or County License 0 Q
If value of construction Is S2500 or mom. a Rcrnoncn A1...1
._�...�.,.......... LLcu.e11115 regUirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
'Y
Name: — -- _
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
COMPANY: Not
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conWict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie CountyAmendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences; walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A'Nirria OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENfFMFiuT"
SignatuFe6f Owner/ Lessee/Contractor as Agent for Owner
STATE OF
COUNTY OF FLORIDA.... i t 1C� .\=
The for Ding in men was acknowledged_before me
this day off M » 20 `�,j- by
Name of person makhrig statement.
Personally Known Y OR Produced Identification
Type of Identification
Commission
rm7s$ion N GG 1
Commission E
Holder
STATE OF FLORIDA
COUNTYOF_
The for Ding instr me t was acknowledged before me
this day o M 261 by
Name of person making statement.
Personally Known ' OR Produced Identification
Type of Identification
Produced
REVIEWS I FRONT I ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
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My Commission
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