HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1 PermltNumber. 1 q \d 1��
SCANNED RECEIVED
BY
St. Lucie County APR 0 g 2019
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_ Building Permit Applic tion
Planning and Development Services ST. Lucie County,_ permitting
Building and Code Regulation Division '-
2300 Virginia Avenue, Fort Pierce FL 349B2 /
Phone: (772)462-1S53 Fax:(772)462-1578 Commercial Residential L/
PERMITTYPE:
Address: 25- t Cl
Property Tax lD #: /Y /i- 70/ - 0/2-9 COO-1/ Lot No. l!
Site Plan Name: Block No.
Project Name:
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GONSTRUCfiONHNFORMl1TION
Additional work to be performed. under this permit -check all that apply:
_Mechanical _GasTank _Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3Y90 Utilities: _Sewer _Septic Building Height:
Name Y11
Name:
Address: /2A er 4 Ch4.
Company:
rh: % State: E(-
Address. /n
ZipCode: 31;r`j 4S Fax:
City;/f�Pi State: Fl
Phone No.0% -5 7' - /SSl7%
Zip Code: .4?. 9C-X1_ Fax: 32� J29 �So7
E-Mail: i-e 4/0 7. ro"
Phone No 2,�72i <'
Fill in fee simple Title Holder 04 next page ( if different
E-Mail /l�aPrE(l�i?2�F'e�/.�✓,+�:nd .t ;
from the Owner listed above), ,._
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC Is $7,500 or more; a RECORDED Notice of commencement is required.
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STRUCTI0N
SUPPL'EMENTALACON3LIEN LAW INFORMA710N
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City: State:_
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
uwtveny L.UNTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work orinstallation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the$ermlt holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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.
Inconsideration 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 A111.117MONFY RFFnDF DFrnnnwr vnun entire ne rnuuivrvur�m n
as
STATE OF FLORIDAq /1
COUNTY OF 1Atfum %r ✓�/
Thefo ngins
this day of
Type
Commission No.
1;139L�iTF'f
acknowledged before me The for sing instru ent was acknowledgedbefore me
r 2004 by this � day of Ap 2pr, by
17
tfement. Name of person making state ent.
OR Produced Identification _ Personally Known I/ OR Produced Identification
Type of Identification
194783
ZONINGFRONT COUNTER I REVIEW I SREVIEW R REVI W I VREVIEWON I REVIEW I MREVIEW