HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO" MUST BE _".JIPLETED FOR APPLICATION TO BE ACCEPT,-
Date: Permit Number:
RECEIVED
Building Permit Application
MAR 2 3 1021
Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
Property Tax ID #: Block No. Lot No.
.� .
•
Site Plan Name:
Project Name:
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: �--�
C-os onstrd tion: $ ��
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
State -
I �Fill in fee simple Title Holder on next p e(i differe t
.0 the Owner listed above)
Name:
Company:
Address. --
Zip Code:
Pne No
E-M+ail
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.
Building Height:
Fax:
State:
DESIGNER/ENGINEER: Not Applicab
Name:
Address:
City:
Zip: Pho
State
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:_
— Not Applicable
State:
Not Applicable
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
NEY'BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
@yITH YOUR LENDER OR AN A a
Signa re of caner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S1 _LLR AI./
COUNTY OF
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_, by
this day of ij--, 20_7—J by
_
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification —0""
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced 1(
Produced
�n}d5 Noi�.
=�9t
�oy�
,
(Signature of Notary Public tat of Florida)
"'"w``
(Signature of Notary Public- State of Florida )
Kom=
Commission No. (Seal
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Commission No. (Seal)
Cr®e
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REVIEWS
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VEGETATION ,
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REVIEW
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
DATE
p
RECEIVED
m ` 70
DATE
i v
COMPLETED
Rev. 2/7/19