HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C� Permit Number:
SCANNED
BY
St. Lucie County
AUG 2 0 2019
Building Permit Application
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
I PERMITTYPE: Lzw I
PropertyTax]D#:
Site Plan Name:
Project Name:
Additional work to be performed under this permit —check all that apply:
—Mechanical
X Electric
Gas Tank
— Plumbing
Total Sq. Ft of Construction:
,ost of Constro ion:� e)LkR?�. r
— Gas Piping
— Sprinklers
Lot No.
Block No.
— Shutters —Windows/Doors
— Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
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Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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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.
DESIGNER/ENGINEER:
—NotApplicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone --
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
—NotApplicable
Name:
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 Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conlict with any applicable Home Owners Association rules, bylaws or anecovenants 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 IMPROYENEMTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SIITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIITH YOUR LENDER OR AN ATrORNEY BEFORE RECORDINr YOUR NOT12F OF CnMMFNCFMFNT "
Signature of,Owner^essee/CbZntractoras Agent -for _wner--�
Signat6reof Contracfor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
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Name of Pierson making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
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