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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Vq , d y G1 Building Permit Application[:R:ECEITE�D— V 2018Planning and Development Services Building and Code Regulation Divisiony, Pernjlftlf I 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: YN PR•POSED IN R0IJEME T 1.•CATIO Address: I/t��s '7'�- /�i .✓ ,'c c ez PropertyTax ID#: Lot No. Site Plan Name: Block No. Project Name: DETA'LED DE=SbWTION OF WORK: 71 Z c 1�-STR- Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping —Shutters _Wiridows/Doors Electric _Plumbing _Sprinklers _Generator _"Roof, Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: OWNER/LESSE: DONT ACTOR: Name / - Narne: Address: o ?ic/E_ / City: � State: ;!Address: Zip Code: CIZ Fax: City':'•, --State: Phone No0 /d, Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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. PPLEMENTAL CQNSTRU'CTI©N L IEN LAW IN (+)RMATIO 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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the'%o k,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 wrll,`in all4respects,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. - Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLCQRIDA STATE OF FLORIDA COUNTY OF SS-k. V v c�`� COUNTY OF The for oing instru ent was acknowledged before me The forgoing instrument was acknowledged before me a this day of ��� 2011 by this day of 20_ by ck 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 'F` IQ L' Produced (Signature of Notaryublic-State NAMpR1EG 23(Si ature of Notary Public-State of Florida) DEi� GG 022 � : COMMISSION ber 16,20 0 Commission No. �d1 g (Se �S:Dece bficUnda ission No. (Seal) SiAd1Notary REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED iev. 9/26/18