HomeMy WebLinkAboutBuilding PermitAll APPLIC E IN OST BE CQMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z I Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: ARIC
'C—Tt(q2�<
PROPOSED IMPRO EMENT LOCATION:
Address: 11 �jE 4
Property Tax ID #:w �_ L vv Lot No.
�
Site Plan Name: Block No,.
Project Name
Addit' nal 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 Constructi
Cost of Construction: $
Sq. Ft. of First Floor: _
Utilities: —Sewer Septic
Building Height:
nil
OWNERAESSEE:
CONTR OR:
Name
Name:
T�rWAddress: Company. 6
City: State.
Zip Code: ax —�
Phone No. +
Ad s:
City State
Zip Code: Fax:
Phone No '1-1
E-Mail:
Fill in fee si ple Title Holder on next page ( if different
from the Owner listed above)
E-Mailer
State or County License
If value of construction is 52500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
j
jMATIOW
DESIGNER/ENGINEER: _ _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
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.
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."
S re oT Owner/ sse ontractor as Agent for Owner
Sign at reef Contractor/license older
STATE OF FLORIDA .
COUNTY OF l�
STATE OF FLORIDA � _ .
COUNTY OF ____
The ing inst e i is ckn wled �Pefore me
this day of 201-1 by
Th rng ins u owled efore me
this .... _ ay of 2t} by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
Name of person making,statement.
Personally Known , OR Produced Identification_
Type of Identification
! ProAuced
nat e u
007
Commissio r Se
a
(Signatur b Ide
Nzado
Commissi H007Ma1)
+A �Cpires 0V 024
or
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19