HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
��
Date: SCANNED Permit Number:
D
_ — BY � ✓0zt��/�FO
? n 1p19
St. Lucie County p"sm rti
12
9
• • �Lp; D,
- - - --- Building Permit Application e�o;�yet
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
2 9,Z
Address: 4 516q mn rl-6e 4�(�X�600
Property Tax ID #: 3 r r Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DES@RIPTION OF WORK:
D/a�PMPy �� dl�1C/�•• Shed G'o.�sfruCf2ii :s�eri�r
f /" /
1
•ONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical — Gas Tank _ Gas Piping _Shutters _ Windows/Doors
Electric _ Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: c?�J99 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRAC««TOR:
Pl me
Name:
Aress: 6v Y
Company:
. ICI
Yl ofy-( 31H,52 state: j
Address:
City:' State:_
�ity:
( ipCode:3�l�c�f�% Fax:
one No. Ma- �i%
Zip Code: Fax:
Mail:
Phone No
F, in fee simple Title Holder on next page ( if different
E-Mail -
State or County License4
,f m the Owner listed above)
I� alue of construMion 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.
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."
ev.
S PPLEMENTAL •ONSTR
DESIGNER/ENGINEER:
Name:
CTION
Not Applicable
N
� MAT ON:
'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:
Sig ature of Owner/ L ssee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The rgoing instrume t was acknowledged before me
The forgoing instrument was acknowledged before me
this ay of
20� by
this _day of , 20_ by
x`M�5
Name of person mak statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatior�
Type of Identification
Produced 1� �i��
Produced
(Signature of Notary Public- St
of Florida)
(Signature of Notary Public -State of Florida )
Commission No.
a
Commission No. (Seal)
ELLEN VAUGHN
- '
ommisslon # G
270079
REVIEWS
(41UIt�sslo
Sk{R�3VI R
PLANS
VEGETATION
SEATURTLE
MANGROVE
r 22,
20 VIE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
19
DATE
COMPLETED