HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: !aa k\� Permit Number.\Z\d
f3 ;
RECEIVED
Building Permit Applicatio JAN 2 2 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT APPLICATION FOR: oivtk L
'PRnP(14Fi11l\IPRnVFMFNT vnrATl(1N•'` °
Address:
Legal Description:
Property Tax ID
Site Plan Name:
Project Name: _
Setbacks Fror
�-t\'i T7
St. Lucie
#: Ala-<Z-)A -0Z,6z--64Q —S Lot No.
Block No. _
Back: Right Side: Left Side:
[CONSTRUCTION INFORMATION;
Adaitiona wor to ape orme uncierthis permit- c check all that apply:
_Mechanical _ Gas Tank Gas Piping _Shutters —Windows/Doors
4&aiz_
_ Electric _ Plumbing _ Sprinklers _ Generator Roof 1 b eLPitch
Total Sq. Ft of Construction: 7JDW
Cost of Construction: $ Od
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Building Height: fo I
'OWNER/LESSEES e
CONTRACTOR:
Name t14
Name:
Addres : LL�f
Company:
i
City: W Lua., State��
Zip Code :,q4Q916 Fax::
Phone No. r%%Z �" ,LLzJ-7�
Addre s:
City: State:_
Zip Code:
Phone No `"
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail a - ` ..
�N
State or ounty License
If value of construction is 2500 or more, a RECORDED Notice of Commencemerft is required.
OWNER/ CONTRACTOR•AFFIDVIT: Application is hereby made to obtain a permit fo 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
is in Home Owners Association bylaws covenants that such
which conflict with any applicable rules, or and may restrictor prohibit
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 accessoryd'ses 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
commencingwork or recordingour Notice of Commencement.
L
SUPPLEMENTAL COIVSTE2UCTI01�LIEN
LAW�;INFORIViATI01U.DESIGNER/ENGINEER:Not
Name:
ApplicableMORTGAGE
COMPANY:Not
Name:
Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
�,�Not Applicable
BONDING COMPANY:
Name:
�of Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip:Phone:
Sign�atroofOwner/Lessee/ContractorasAgentforOwnerSignat�Contractor/LicenseHolder,STATE
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this22jj"��d��ayof _S20�`�by
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