HomeMy WebLinkAboutBuilding Permit Application IAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
. N Agriculture Exempt 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
PERMITTYPE:
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✓Address: TO D S NeQdP,r OA-vlG T f o(4 PierCf n 3 q 9 81
Property Tax ID#: 32-0-2 - O dO - COOS `060C—,e Lot No. S
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Cost of Construction:$ Total Sq. Ft of Construction:
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ame 3 Name:
Address: 971 RJ PJ �horP fll yd Company:
City:Tor 4- S)-. Lic 1 e $ State: 1' Address:_
Zip Code: '5 Ll 5 9"') Fax: City: State:
Phone No. 7 7 2- 1 Zip Code: Fax: _
f E-Mail: 2.jcjsoy7 -I lct?zeQW 1I CO Phone No _
Fill in fee simple Title Bolder on next page(if different E-Mail_ _
from the Owner listed above) State or County License
If Value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ✓Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x^ot Applicable BONDING COMPANY: _'Not Applicable
Name: Name:
Address: Address:
i 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."
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Sig ature of Owner/L ee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 2 `Z`by this day of 20_ by
n2a-1(1 i& 6r- t Z
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Name of person making sta ment. Name of person making statement.
Personally Known d ti is t'o Personally Known OR Produced Identification
Type of Identifica no�,s•P%� Notary Public State of Florida Type of Identification
Produced :ILA f' Jessica Produced
'?of�owP` Expires 04/14/2024 970887
(Signature of Notary ub ta ,,v�Flor' � P lic State of Florida ignature of Notary Public-State of Florida)
Je ' Luna
Commission No. A� mission 970887 mmission No. Seal
-xpi '�0411412024
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.