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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: / Permit Number: 7 KLCEIVED 0 ED _�_�.. _� � _ - LPermitting AN 11 2019 Now Building Permit Application Planning and Development Services De artm e n tBuilding and Code Regulation Division Ie C2300 Virginia Avenue,Fort Pierce FL 34982 Un ty, FLPhone: (772)462-1553 Fax: (772)462-1578 Commercial R PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED-IMPROVEMENT LO TION Address: c<e– Al �- Legal Description: PropertyTax ID#: / O36 _4000 1 Lot No. G Site Plan Name:. Block No.� Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK r 9 'CONSTRUCTION INFORMATION. Additional work toM,9as orme. under this permit—c ec a appy: HVAC Tank E]Gas Piping _Shutters ❑Windows/Doors 11Electric R/ Plumbing S rinklers 1:1Generator ❑ Roof Roof pitch — — g I.-.nJ p — — Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$�7l ,O, Utilities: Sewer Septic Building Height: OWNER/LESSEE:, .f CONTRACTOR: Name S 1AM6 1 6 Name: i Address: ll '1 �• Company: City: ect, Statex-- Address: 9,• C , Zip Code: oAFFaax�: City: _ State�/. Phone No. ��, 10- & Zip Code,�,►� Fax: r - •/ E-Mail: Phone No..� r• y��� Fill in fee simple Title Holder on next page(if different E-Mail: 1* ©oa from the Owner listed above) State or County License: d / ��f If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENTAL,CONSTRUCTION LIEN LAW INFORMATION: 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 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 thepermit 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 commepcing work or recording our Notice o Comm encement. 11AAL Sign ur o caner/Lessee/Contra r Agent for Owner Signa ur of on r i ocense Hold STATE OF FLORID J STATE OF FLOR Ag COUNTY OF f i o�, COUNTYOF =a[ 'L9 Al The forgoing instrument was acknowledged before me The forgoing instEument was acknowledged before me this _day of IJ�� 204 by this day of 20J9 by o erson making stater fent f person,makings tement Personally Known OR Produced Identification ersonally Known OR Produced Identification e of ation ati donn Prod Produced a ,n ­151111,9na gnature of Not .S,'g'vrGh LIBERTY A.KING ;q: �°: ,� LIBER A KI G ' OMMISSION#GG MYCOMMISSI Commiss •N •:= Commission No. ;•= 90838 ; gyp py ay 4,2021 P,, EXPIRES:May 021 Bonded Thru Notary Public Underwriters ' �f;° Bonded Thor Notary Public undenniters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17