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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEy W FOR APPLICATION TO BE ACCEPTED
Date: 1 Permit Number:
RECEIVED
SEP 112018
Building Permit Applic Lo,_ie County, Per
Planning, and Development Services BY
Building and Code Regulation Division UCI@ CO161��1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: S�
PR�� POSED INPR©VEM�ENT Lt�?CATI'ON: +
,/
Address: 1 700 / DST WA
Legal Des. * tion: L® 1-7
Property
Tax ID IT: /go l &o it ��1�� 0040 % Lot No.�
Site Plan
j lame: Block No.
Project Name:
®�
Setbacks
Front Back: ;" Right Side: Left Side:
.r
®ET ILED
DE=�SCRIPTI®N OF WORK•
:L/V e le, -airy;
C®NSTRUCTI(!1N IN'F� �+MATItJN:
Additional work to be per orme.. under this permit. -, Check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters ✓Windows/Doors
,Kei tric tubing _Sprinklers _Generator ✓fZoof C9 / Z Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: •3
?ate 9
Cost of Construction: $ ^ Utilities: —Sewer 1� Soreptic Building-Hei ht* r
o
OW N ER/LESSEE:
MNTRACTUR:
Name: 2 O fP
Name �
Company:e /02Sra
'''-11
Address W
Address: 4a 7< 4►.fo 1
City: State
ZipCode: Fax: '��
City: D S L State:_W
Phone No.
Zip Code: 2 q*fr 6 Fax:
E-Mail: ,
hone No � VIA !C� / 7
Fill in fee situ le Tit a Holder on next pageJ ( different '
E-Mail
from the Owner listed above)
State or unty Lic nse
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
G
i
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,l 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 resultjn ,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
commencingwork or recordingour Notice of Commencement.
e
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:
Address':,
Name:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Si nature of Con actor/Licen
Signature of ner/ Lessee/C tractor as,Agent for Owner