HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / O
Date: Permit Number:
SCANNED
BYRECEIVED
• St. Lucie County
- �— - - Building Permit Applicati n AUG 19 2019
Planning and Development Services sT. Lucie County, Permitting
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:
Aa s: O 2 4 i
u
P.ropertl T- D #. 0I � 00 { Lot No. (P
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additio na I wo rk to be perfo rm ed uriderthispermit— checkaIIthatapply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _'Roof Pitch
Total-SgiFt of Construction: 3 (o0 S Sq. Ft. of First Floor:
Cost,`of'Construction: $ "l 00 Utilities: _ Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
N me a ate/ ��
Name:
Ad dress:
t / (mot. V
Company: _.
City: t Stat
Address:
1
City: State: —
Zip Code: Fax:
Zip Code: Fax:
Phone No.— 7
II Mail:— - =1� e ,r 4 K o' K a fJ it'
Phone No =
\Fill'in f simple Title Holder on next page ( if different
E-Mail
State or County License
from the Owner listed above)
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.
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 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.
UPP E PNTrA CONS RU
10 L LA I
O
MORTGAGE COMPANY:
Name:
Not Applicable
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_Not Applicable
-BONDING -COMPANY:
Name:
_NotApplicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Si ature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO��DA
STATE OF FLORIDA
COUNTY OF ; jA . t1
COUNTY OF
The fo oing instr me was acknowledge before me
The forgoing instrument was acknowledged before me
this day of 20by
this _day of , 20_ by
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