HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SCANNED
' BY RECEIVED
St Lucia Munty
• MAY 112018
_ Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address:
Legal Description:
e n11- I �ovyv zle,
Property Tax ID #: "L 30 0 -700 r C00-7 , CX;ln- 2.- Lot No.
Site Plan Name:,( Block No.
Y Project.Name: ������DY
Cathartic Prnnt Rnrk Riaht Side- I Pft Sidi-
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _i Sprinklers _ Generator
Total Sq. Ft of Construction: �3291 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
' '1J'UNER�I.E-�S�SEE; ,�
CONTRACT®R:
Name LQ�9�
lid
Name:
Address: (jr-►9' .av
Company: 20-10
City:_ ��/'c� State: r&
Zip Code:,RtZ% r� Fax:
Phone No. �%o� - ! �l
Address:/'iv��f���`�
City: 1% �%,c�� c� Stater
Zip Code: -�:9 Fax:
Phone No 79,)- VI? W
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ,e/` %t ! f ( ��' f, G
State or ounty License 4 B e-
If value of construction is 2500 or more, a RECORDED;Notice of Commencement is required.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name: _.. ... _
[�Address:
Address:
City:
State:
City: State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name: '
I
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, sig6s; 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 firs If you intend to obtain financing, consult wi ender or attorney before
commencifirw rk or r2ordinavour Notice of Commencement.
r as
STATE OF FLORIn V.,l �I s COUNTY OF
The f r oing instrument was acknowledg a
q �
this / day of 2 _ b P g =
o
$ m T xx
8N
(Name oWl son acknowledging )
(Signature of Not ublic- tate of Florida )
Personally. Known. OR Produced Identification
Type of Identification
Produced
Commission No.
(Seal)
Signatu6f C acgf/Lic Holder. .
i'/ I
STATE O F RID r�
COUN
The forgoing instrument was acknowledged b fjrp;�
this day of _%�m�
J) in) aM n
(Name of persoo acknowledging )
(Signature of NotdW Public- State of Florida )
Personally Knowne__�OR Produced Identification
Type of Identification
Produced
Commission No. I 'I (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014