HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APP
Date:
INFO.MUST BE CON ' ,`TED FOR APPLICATION TO BE ACCEPTED `
Permit Number:
WRAMMED
csaw' RECEIVED
Building Permit Application AUG 0.2 7010
Plannin i and Development Services Permitting DepartmentSt. Lucie County
Buildin and Code Regulation Division
2300 V1 r(772)
inia Avenue, Fort Pierce FL 34982
Phone 462-1553 Fax: (772) 462-1578 Commercial Residential
PropertViTax ID #: +c-�� ��� l — DD/tSDAf ., Lot No.
Site Plan Name: /1� �1Tw1_[+�n►� Block No.
Project Came:
Setback Front r Back: /� 2 Right Side:. Left Side: ,7,4
Additiol al work to be performed under this permit - check all that apply:
—Mechanical _ Gas Tank _ Gas Piping _ Shutters. Windows/Doors
_ EI ctric _ Plumbing _ Sp'nklers _ Generator _ Roof Pitch
Total Sq Ft of Construction: 2 yDa Sq. Ft. of First Floor:
Cost of construction: $ 3 Sogn Utilities: —Sewer —Septic Building Height:
II II i
011VN
ER/LE=�S�SEE:
CONTRACT®'R:
Name
Addrei
City:
Zip Code:
Phon iJ
E-Mai(
Fill in
from t
is Tr b6apic
Name: noff0i Co;" 14.�
s: /'oo& wove- L-r-
Company: C .v .-
"?' f%ie yea State:
�TO9" Fax:
No. '�? L - Z/� - G 2 yam_
Address: Z
City: e/'o State: E_K
Zip Code: 3% 9L Fax %�� •�T�- 5^.0
Phone No 77�P_ • 5_-T79 - y 7 ;?
lee simple Title Holder on next page ( if different
e Owner listed above)
E-Mail e'lo ;6C
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State or ounty License t icip 2.S-'9��
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUS •�PLEMENTAL C(JNSOlJ IQN LI �N LAW 1'N�FQR�MA
14 .;
DESIGNER/ENGINEER: _ Not Applicable
FMORTGAGF COMPANY: Not Applicable
Name:
_
�N'afne:
Address:
Add'ress:
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 respecfs,.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, waIIs, -sign s,`screen rooms an'd accessory uses to'another non-residential use i
WARNING TO OWNER: Your failure to Record a Notice of Commencement•rnay 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 ari attorney before
commencing work or recording: -your Notice of Commencement. �,r1
Signatu Owner/ Lessee/Contractor as Agent for Owner
Signat f Contra /L' ense Ho er
STATE.OF FLORID
'+
ST .. TE OF FLORIDA
COUNTY OF
j�
The fo oing instr ent was acknowledged before me
this day of 2 by
The f oing instru ent was acknowledg before me
this day of 20LO by
(Name o , erson acknowledging)
(Name person acknowledging)
IL
(Sin e o Notary Public- State of Flo ' )
(Signature of Notary Public- State of oride )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
.Type of Identification
Type of Identification
Produced
Produced
-ComMission,No. (Seal)
Commission No. `.. (Seal) .;
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS.
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
'REVIEW
REVIEW'
REVIEW
DATE
RECEIVED _ ..
I
DATE'
COMPLETED
Rev.7/201.4