HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAh
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE
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PECEIVED
Building Permit• • 'kP.rJLciieCountY Permitting
Planning and Development
Building • and Code RegulationDivision
II Virginia Avenue, Fort/
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_Mechanical _ Gas Tank _ Gas Piping
y lectric Y Plumbing _Sprinklers
Total Sq. Ft of Construction: , I/oZCJ
Cost of Construction: $ Vim/,- /%•
_ Shutters
_ Generator
Sq. R. of First Floor:
Windows/Doors
_ Roof
Utilities: _Sewer _Septic Building Height:
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Fill in fee simple Title Holder on next page (if
from the •
d! ereni
& County/
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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City: /!> State: �
Zip: Ph —one ��
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
Address:
City:
Zip:
Phone:
BONDING COMPANY: _Not Applicable
Address:
Zip:
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
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WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements toy ur 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
o rnmmanrinwnrlr nr rprnrdina vnur Nntirp of Cnmmencement.
Signatur t/ Lessee/Contractor
Signature of Contractor/License Holder
STATE rOFO //�,
b
STATE OF FLORI�A�ICOUN
, [V G d;
COUNTY OF L 1
The forgoing instrument was acknowledged before me
The f r ping instrum nt was acknowledge fore me
tfiis �l'day of ��/�- 26JI by
this; day of 20 y
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A/
(N eerson acknowledging) i e 0 �r },a> L(C ,
(Na f erson a ledging )
( ign ure of Nota a e of Florida)
(Sign ure of Notary to of Florida )
P rsonally K OR Produced Identification —
Personally Known OR Produced Identification
Type of Identi ation 1
Type of Identification
Produced 4„�G Re1>acca U
�y%,.
Modred ��YFOa- SHERRIFEHLMAN
commmso�xccta7tso
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,a commissions
Commission.No. - ( I)" 4
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6pi MIssionNo. % �(Se�sMarch14,2022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
RE IEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
F
COMPLETED
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Rev.7/2014