HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: IN • 001c)
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• St. Lucie Cnnnftl 05 �p19
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- Building Permit Application %tg�ePoty
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Planning and Development Services Pe s,i �d'
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-IS78 Commercial Residential
PERMIT TYPE. N)-/fig LJi , 4 PZ�t TTaL
PROPOS -D
IMPROUEM =NT LOCAL ON:
A M 9) Ooc7 Yewii l 4 Fr. P i e %Lc E I FL 3 4q S
Lot No.
Site Plan Name: Block No.
Project Name:
DETFAILED DESCRIPTION fO FAMRK:
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W t v`l O W V, C, N T atN YtU tL. JL I C (A t (— NUJ r t Es.'s
CONSTRUCTION INFORMATIO
Additional work to be performed under this permit — check;all that apply:
_Mechanical _Gas Tank _Gas Piping =_I Shutters ^: Windows/Doors
_ Electric _ Plumbing _Sprinklers ' j : L_, Generator _Roof 7 Pitch "
+ L V
V
Total of First
Sq. Ft of Construction: Sq: Ft.' Floor:
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•ost o Construction^ �' talgvci` Utilities: `:Sewi.
er -Septic Building Height:
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NER/LESSEE:
CONTRACTOR:
me C R,tO 1rLkJ AF A 0 E
'Name:"
Address: (3cm CNKy LP4
Company:
City: VT- P iVI.C6 State: _
Address:
City: State:_
Zip Code: 1 34-IS I Fax:
Phone No. GOO SI 4'L
Zip Code: Fax:
E-Mail:
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
State or County License
om 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.
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MMILEW1P iFAL CO TR
CTlON
PO A 0
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip:—; -----=''.-Phone-__
State:
City: State:
Zip: Phone:
FEE SIMPLE -TITLE-HOLDER:
Name:
_ Not Applicable
BONDING COMPANY _Not Applicable
Name:
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 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."
STignature of Owner/ Lessee/Contractor as Agent for
Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
m
STATE OF FLORIDA
_
COUNTY OF
COUNTY OF
The f oing instru ent was acknowledge efore
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The forgoing instrument was acknowledged before me
this day of 20 by
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this day of , 20_ by
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Name of person making statement.
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Name of person making statement.
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Personally no OR Produced Identificat
n
Personally Known OR Produced Identification
Type of Identific ��
o,
Type of Identification
Produced i �` / � .
zv
` _
Produced
(Signature of No ry Public- State of Florid )
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED