HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR' APPLICATION TO BE ACCEPTED • / /,�
Date: - - ) % I Permit Number: l �/ 07— 0 4U o 0
mEtTIVED
Building Permit Ap licatiobUL 26 2019
Planning and Development Services "Permlttln Building and Code Regulation Division g Department
2300 Virginia Avenue, Fort Pierce FL 34982 St
l1CJP� COtI flt�/, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMITTYPE: /ff,,„„S4- . r
PropertyTaxlD#: ��J�� "_c112,—��— 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 Windows/Doors
V Electric Plumbing _ Sprinklers _ Generator : L'60f Pitch
Total Sq. Ft of Construction: �� Sq. Ft. of First Floor:
Cost of Construction: $ j dam) Utilities: _ Sewer _ Septic Building Height:
OWNERJLE�SSE
CO TRACTOR:
Name 47YP,nIo j sco p.UiWL PYG--72-
Name:
Address: 2g0,r1 1k) 00-11 5h-,,-+ r
Company:
City: State: JcL
Zip Code: Fax:
Phone No.- S6/ - -- 65 O
Address:-:_.,
City.-" 1 0 „ , State:
Zip Code: *0 Fax:
Phone.No•..-:-!_
E-Mail: S
Fill in fee simple Title Holder on next page ( if diffe ent
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.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: pe rr,7_- Name:
Add.r_ess:..ZQdui Address:
City:, place; State: f=C City: State:
Zip: ,-Phone�Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable I BONDING COMPANY: Not Applicable
Name:
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 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 LENDY
JtflEEANIATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
i
Signature of ner/ Lessee/Contractor s Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA -.
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The fRrgoing instru ent was acknowledggj�efore me
this day of 20/ by
The forgoing instrument was acknowledged before me
this day of 20_ by
(!�=-
Name of person making statement.
Name of person making statement.
Personal) wn OR Produced Identification /Personally
Known OR Produced Identification
Type of Identifi tion
Type of Identification
Produced -
Produced
rl
(77h;alt�ure of ota ublic- State o lorida)Y
(Signature of Notary Public- State of Florida )
Commission No. UDREYbS PHREY
*- MY COMMISSION # GG 300817
Commission No. (Seal)
REVIEWS
prFOFv;°e'Ec
rided Thru Notary Pub'c
' n e ' e
R
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19