HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST`` BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —5-" (2\ llSf Permit Number: 13
REC
° - MAR 6 2019 ED
Building Permit Applica ion
Permittin D
Planning and Development Services 9 Depart
Building and Code Regulation Division St. Lucie County, FL.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: SCANNED
PROPOSED IMPROVEMENT LOCATION; St. Lucie,Colint
Address: d\JU b
I L\ • r
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION.OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: o Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: _Sewer _Septic
Windows/Doors
-7'30of Pitch
Building Height:
OWNERAESSEE:
-CONTRACTOR:
Name
i _
Name: t`e 2 4
Address: YC:
Company: 2`C( .
City: State: IL
7711
Zip Code: ` l Fax: S
Phone No. !7::�
Address:
City: State:
Zip Code: '� Qq5 Fax:
Phone No d
-:2
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 0_
State or County License CCC, L
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
MORTGAGE COMPANY:
Name
Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Zip:
Not Applicable I BONDING COMPANY: _Not Applicable
Name:
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
"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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN'ATTORNEY BEFORE RECORDING -YOUR NOTICE OF COMMENCEMENT"
�N
9igg'ata of Owner/ Lessee/Contractor as-7qent for
Sign Contractor/License Holder�
STATE OF FLORI
STATE OF FLORID
COUNTY OF
COUNTY OF
a chi 's
The forgoing instrument was acknowledgee,d before
m / !�
z
The forgoing instr epY uyas acknowledged befor
Gt C i
this day of f� Je (� 71 20 by
-Da
m= 3
this (O day of . 20� by
1 i 11. i
Q)A/ 1
)
I e�Yr�S
Name of person making statement.
< &
Name of person making statement. �E ;��
�••
Personally Known OR Produced Identifica
p"'::'
.sue_
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Personally Known OR Produced Identifi a:
..... ..
Type clf ti ation
Produce - r,
Type of en ion ,.a .•J
Produced C .
4ure of No ry Public- State of Florida)
(Signature of Noto Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
13.07
DATE
COMPLETED
110
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