HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLET`s 1'OR APPLICATION TO BE ACCEPTED ii (� 1
Date: �� ( Permit Number: L '0::. )�31 J
SCANNED
BY
St. Lucie CoumeD
Building Permit Application MAR 13 1018
Planning and Development Services
Building and Code Regulation Division permitting oepartmont
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie county
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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Site Plan Name:
Project Name:
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Additional work'to be performed. under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing Sprinklers _ Generator
algFstruction--:L�I Sq. Ft. of First Floor: _
xof,Construction:$ Utilities: _Sewer _Septic
-Windows/Doors
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Building Height:
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Name:
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Company:
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Zip Code: 3 q9 �S' I Fax:" /
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Phone No. ' l n D Z c;—p O r (P q
State:
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Address:
City:
Zip Code:
Phone No
State:_
Fax:
E-Mail: o, e u a Jc� h oo. n
LI m esimple Title Holder on next page
from the Owner listed above)
if different
E-Mail
State or County License
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.
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip:
Phone
State:
City:
Zip:
Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
c_ommencing work :or recording your,Notice-bf Commencement.
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'S@h16preq&wnviT Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
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STATE OF FLORIDA
COUNTYOF -LOc.N�
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this_ day of 20g by
this _ day of . 20_ by
_J e+,eg0•,\'kv%a A\COC. '
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced i-
Produced
(Signature of Nota IIEGMNs
(Signature of Notary Public- State of Florida )
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Commission NO. (Seal)
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PLANS
VEGETATION
SEATURTLE
MANGROVE
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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