HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONti
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _�6\ It\ v\
Permit Number: �`�\d'dal \
SCANNED 10
BY RECEIVED
St. Lucie County
------ — Building Permit Applicat.n OCT 11 ?G?9
i
Planning and Development Services ST. Lucle County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT TYPE:
Address:
Property Tax ID #: 3'.�v� (f/ d Od Q Lot No.
Site Plan Name
Project Name:
under this permit— check all that apply:
/Lewindows/Doors
_ Electric/ O ry Plumbing fvSprinklers %OGenerator � Roof j Pitch
Total Sq. Ft of Construction: / 6(go
Cost of Construction: $ J, Clod
Sq. Ft. of First Floor: / ?11C2
Utilities: Sewer Septic B ' ding Height:
ire. /r��ao�i n"zf!y'o¢E
OWNER/LESSEE:
Name
G9,NTRACTQR:
Name:
Address. d'd
Company:
City: Stater
Zip Code: Fax:
Phone No. `7 �'?��� L +
Address:
City: State:_
Zip Code: Fax:
e No
E-Mail: / 3 6 Z;yOr�
r
Fill in fee simple Title Holder on n xt page ( if different
from the Owner listed above)
E-Mail
State or County License,!
i
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requiret.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAN ISRRUCTION I LI -N WIN
DESIGNER/ENGINEER: _ Not Applicable
Name:A
--13. MA ON:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: S
Address:
City: lk State:
Zip g� _Phone % _Zip:
City: State:
Phone: --_ _ _—
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
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_"
. .
ut Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY 5 LOc
STATE OF FLORIDA
OF k, \'Q
COUNTY OF
The forgoing instrument was acknowledged before me
�
The forgoing instrument was acknowledged before me
this �day of 20 � by
this day of .20_ by
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
Produced
GNEt1S
(Signature of Nota l�jcj: to of IDIigGG
' 8 ITS �2e
(Signature of Notary Public -State of Florida )
=to
"' EI(PIRES: December
Umle
Commission No. w gadeall�[ ry -
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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