HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' / V SCANNED Permit Number.
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BY
St Lucie County RECEIVE®
Building Permit Applicatior MAY 11 2018
Planning and Development Services ST, Lucid County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Comlirnercial Residential X
PERMIT APPLICATION FOR: Roof
Address:
Legal Description:
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P roperty Tax I D #: oayl�b- 13`A-00\',*4,•0uUr- li
Site Plan Name: 1 V L r l�C
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Project Name: C u t bu f
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Setbacks Front Back: Right Side: Left Side:
Lot No. (_
Block No. —
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mac. tv,-%6 3�%, �A.1k v'r\&J-t°`"1"�, .
❑ HVAC
Electric
0 Plumbing Sprinklers
Total Sq. Ft of Construction: 311
Cost of Construction: $ J4 3, ao U- O U
ing ❑_ Shutters I❑ Windows/Doors
Generator Roof 5 Roof pitch
S . Ft. of First Floor: Al ZA
Utilities:'nSewer ❑Septic , Building Height:a2 S-}af�t
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Name J .�►�� 1�c� ��
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Address:„ 4,14 L 4' 3-"� C .
Company: fi a o �-
City: '�:wr 7Pi Lc t — .,State: 91.
Addrreess:aSJr 0 S'C—
Zip Code: 3" Ci Fax: r! I 1 A
City: i-[yC 3c q�ZA. L.LCa;t. State:.
Phone No. 774- 5 / 9- 4 a 9 ?
Zip Code:-61495a Fax: ,J� tU
Phone No. '1")a- 9,0%- �6�01fib
E-Mail: lou
E-Mail:
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Fill in fee simple Title Holder on next page (if different
State or County License: `(r `LC 1'3 a.L ig Z p
from the Owner listed above)
It value of construction is $7500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _-- Not Ap
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:
Name:_
Address:
City:_
Zip:
Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Sign ture of Own e essee/Contractor as Agent for Owner
Sig ature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA pp
COUNTY OF ,l_ rJ C 1-c.
COUNTY OFu-
The forgoing instrument was acknowledged before me
The forgoing instrume t was acknowledged b fore me
this /I day of .4 20H by
this � day of 20�y ,
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known -t OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signs re of Notary Public- State of Floqd)
(Sign re of Notary Public- State of Florit►gY
pus" MARK KENNY
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MARKKENNYCommissio>A
Commissirr � Seal
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co on 144499
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Bonded Thru Budget Notw SeMoes
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Rev. 8/2/17