HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED-FOR APPLICATION TO BE ACCEPTED
Permit
Co�1 NTY
F L. O
Building Permit Application
Planning I d Development
Building and Code Regulation Division
2300 Virginia Avenue, / 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V",
PERMIT APPLICATION FOR: ToSelect fromdropbox, click arrow • of
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under this permit—check
all apply:
HVAC EiGasTank [:]Gas Piping Shutters E34inclows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft f First Floor:
• • • • ► r , ■ ■ • Building Height:
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Name-
City: —TQAsQn State: FL
. Code �A
Phone No.
• - • • � �\
Fill in fee simple Title Holder on next page if different
from the
• e or County
If value of construction is 00 or more,a RECORDED
M
W
DESIGNER/ENGINEER: _Not-Applicable. MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
_Signature of Owne ssee/Agent Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLOR
COUNTY OF —A. COUNTY OF
T g ing insti'u nt was acknowlecig d efore me The forgoing instrument was acknowledge before me
t is ay of 20T thi day of 20 a by
(Name of person acknowledging) (Name of*person acknowledging)
A,,,,-�_ D
(Signature o Notary Pub' -State of Florida) ( tgnature of Notary Public-State of Florida) .
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
� ���Commission No. Seal) Commission NoEE b JSK.S (Seal)
cigM MELIS ARMENTO
r. EXPIRES:December28,2016 tirPv MELISAARMENTO
Revised 07/15/2014 ~'Pftt BondedThruNot=PubkUndmnaers � :.s MY COMMISSION II EE 855825
EXPIRES:December 28,2016
III
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COM P LETE 7—,31-4
INITIALS