HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEMu' FOR APPLICATION TO BE ACCEPTED
Date: �' ��',� G Permit Number:
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91 uwipr'All RECEIVED
z � IMFA Building Permit Applicatio APR 18 2018
Planning and Development Services ! ST. Lucie county,Permitting
9
Building and Code Regulation Division !
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: 46271553 Fax: (772) 462-1578 Commercial Residential_
(772)
PERMIT APPLICATION FOR:
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PROPOSED INPROVEMENT LO.CATON:
Address:
egal Description: i
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�roperty Tax ID #: soz• Lot No.
1
Site Plan Name: i Block No.
Project Name:
Setbacks Front. Back: Right Side: ,1� Left Side:' -�
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-DETAILED DESCRIPTION OF WORK
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CONSTRUCTION�INFORMATION ;
*
Additio worK to a per orme un er t is permit - cneCK all that apply
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
otal Sq. Ft of Construction: Q (�� Sq. Ft. of First Floor: �Q
ost of Construction: $ Utilities: —Sewer _Septic Building Height:
WNER%LESSEE ..
CONTRACTOR: ;..
Marne �c`
Name:..®WQ.,(
Company:
Addressn,ln C,
CitY47—na ,R�^D'c State:
Address:
Zip Code Fax:
City: State:
Phone No.1��,� S
E-Mail: o y�'
Zi Code: Fax:
Fill in fee simple Title Makler on next page ( if different
E-Mail
rom the Owner listed above)
State or. County License
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State•
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice off Commencement.
ISign atur�wner/ Lessee/Contractor as Agent -for Owner
STATE OF FLORID4:Z+N
COUNTY OF , �lU L 11:::C >
The for oing instrum nt was acknowledged before me
this day of r,L 20-Lf(by
(Name of persdn acknowledging )
(Signature of Notary Public- State Florida )
Personally Known OR Produced Identification
Type of Identification
Produced
Commission No. (Seal)
N
Signature of Contractor/License Holder .
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of . 20_ by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification
Produced
Commission No. (Seal)
REVIEWS
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SEATURTLE
MANGROVE
COUNTER
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