HomeMy WebLinkAboutBuilding Permit Application I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a 4 )
RECEIVED
�-G 'M OCT 13 2020
■ St.Lucie County
"- - Agriculture Exempt Building Permit Appilea it
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:
PROPOSED IM PROVE
pMENT LOCATION:
Address: `�N I\
Property Tax ID#: Q 5®_0Q)` @11Lot No.
Project Name: "
[DETAILED DESCRIPTION OF WORK:
BCD ki (:z. ZN
(/� ID
CONSTRUCTION"INFORMATION:
Utilities: _Sewer _Septic Sq. Ft. of First Floor:
Cost of Construction: $ Total Sq. Ft of Construction:
FLOODPLAIN DEVELOPMENT PERMIT for structuressexempt,from Building Code that are in the
floodplain:
Nonresidential farm Building: Temp. Bldg./Shed used exclusively for construction
Mobile/Modular.,for temp. construction'office: Bldg. involved in distrib. of electricity:
Other: Flood Zone: BFE: Floodway? Y/N If Y,
No Rise Certificate°with supporting data attached?Y/N
All other applicable state and federal permits shallbe obtained-prior to commencement of
construction.
OWNER/LESSEE: CONTRACTOR:,
NameGft bo'f1�9"l Name:
Address: 1 Company:
City: DSL tate:ft- Address:
Zip Code: 'Wy Fax: N City: State:
Phone No. &12-3C(5• (oCPq.;1I Zip Code: Fax:
E-Mail: /%2•1"; 6PIiVe .dm Phone No
T
Fill in fee simple Title Holder 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.
I - -
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SLIPPLEM ENTAIL,CONSTRUCTION LIEN LAW INFORMATION:
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 Y R L—tWIDER OR AN ATTORJSLEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
e
Signature o ner/'Cess /Contr to as Agent for Owner v Signature of Contractor/License Holder
STATE OF FLORIDA / �� STATE OF FLORIDA
COUNTY OF . .L�)C°�lC, COUNTY OF
The forgoing instriyQelt as acknowledged before The forgoing instrument was acknowledged before me
this day of 2P� by ( 1�p� his day of 20_ by
� mAA
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
IFNI
Type of Ident)ficatio Type of Identification
Produced Produced
C
(Signature of (Signature of Notary Public-State of Florida )
\tiPpy pVB, KAREN S. NIELSEN
��° ° ;State of Florida-N �r� ublic
Commission _ lion # G, 484 Commission No. (Seal)
uJinniss=�
My Comir.ission Expires
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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