HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr"
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ► /� �/�
Date: SCANNED Permit Number: lG O " I 045
_ •..w� BY
St. Lucie County RECEIVED
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Building Permit Application De APR 0 9 2018
018
Planning and Development Services Permitting P
artment
St. Lucie county
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
PERMITTYPE:
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
ETAILED'DESCRIPTION OF WORK:
Block No. S
CONSTRUCTION INFORMATION::.
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric ZPlumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: S rL Sq. Ft. of First Floor: _q 12
Cost of Construction: $ 20. 00C) Utilities: ✓ Sewer _ Septic Building Height:
,OWNER/LESSEE: , . ' '
CONTRACTOR:
Name
Name: mccUrve
Address: )4M 15. (MY_)(1cYi PaYY- 6) •
Company:
City: F� . L cknr(' mc_ State: EL
Zip Code: Fax: uL1s
Phone No. 3
AddressA l l') 9aml.1
&Yd .
City: CQ State:—r--t—
Zip Code: N(61 Fax: NI toe
Phone No `n-L - V—) - ZC►lDZ
E-Mail:M YZ0 f(M7CilAn-JJC -COW %
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail"i Keri)d
i�er
110- • wro
State or County Licenseh[— [-
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It value of construction is 52500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
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:
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."
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Sign re of Owner/ Lessee/Ci5mractor as Agent for Owner
Signa re of Contractor/Liceose Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF z5 . UkC A-e
COUNTY OF Sri- . I t
The for ping instrument was acknowledged before me
The forgoing instrument was acknowledged before me
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Name of person making statement.
Name of person making statement.
Personally Known V/ OR Produced Identification
Personally Known vl_� OR Produced Identification
Type of Identification
Type of Identification
Produced
NlotarAyPuilic-
Produced
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(71g4natu State of Florida)
(Signature of Nbtta ubli�c-- State of Florida
Commission No.G9 OT-T tL0� Notary Public Sfat
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