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HomeMy WebLinkAboutBuilding Permit Application y , All APPLIC BLE I FO MUST BE COMPLETED FOR APPLICATION TO BE-ACCEPTED Q Date: 1� � Permit Number: Wr _,I aw: y Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort,Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential j PERMIT TYPE: PROPOSED INPROVEMENT LOCATION: 'Address: �7lC�lo22 '� i-e Property Tax ID#: y ZIJ� '�V D'©�A��%� Lot No. Project Name: �...a.., ,.. DETAILED" DESCRIPTION OF WORK: CONSTRUCTbW NFORMATION: Utilities: _Sewer _Septic Sq. Ft.of First Floor: Cost of Construction: $ �� Total Sq. Ft of Construction: FLOODPLAIN DEVELOPMENT PERMIT:for structures-exempt from Building b z that a'r"e in the floodplain NonresidentialFarm Building Temp::Bldg%Shed used'excl"usively,for°construction ' •IVl6bile/MOdular fd'K" emp construction office Bldg¢Involved�ih dlstrib =of.electricity Flood Zone: "BFE h Floodway?Y/N If Y, NoIRIse:CertiflcateLwith supporting.data attached?Y/N AlUother ay"*"`Iicabldfstate and.federal'°`' ermits,shall be obtained 7'riorAo.commencement of y p "I p P COnstrUCbon 'OWNER/LESSEE' CONTRACTOR: r Name '1 � vS� �-� Name: VLI'1 - -S Compan Address: Lgl �J l�lo �`m��. y,: �\ '7�X City: Stat0 ' Address:r, 1_ r-L_� C-CY ASS �1 Zip Code: ua� Fax: 2 Cit `A'��//t� C_le— State�. d�• Phone N071 � ' �� Zip Coded oto Fax: E-Mail: Phone N •'?_1_). � Fill in fee simple Title Holder on next page(if different E-Mail �(C- vJr a iC�2 r�1Ci. I from the Owner listed above) State or CdLnty License �c 7—q ,i If value of construction is$2500 or more,a RECORDED Notice of Commencement is.required. l If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. £. P .y > }» unp.�_ �SUPREEMENTALiCONSTRUCTION11EN LAW INFORMATION s = M DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMP _Not Applicable Name: Name: Address: Address: City: State: City State: Zip: Phone Phone: FEE SIMPLE TITLE HOLDER: _Not Applic a BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTR OR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no rk or installation has commenced prior to the issuance of a permit. St.Lucie unty makes no representation that is granting a permit will authorize the permit holder to build the subject structure Iwhich-i 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 your Notice of Commencement. C Signature of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Gj� �VC� COUNTY OF The forg ing instru ent was acknowledged before me The forg ing instru ent was acknowledged before me this day of Cf�UCL 20�G by this day of c � 20j_7 by Aucwi 5 �vcv) Pct' rio5 0 Name of person making statement. Name of person making statement. i jPersonally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produc dIProduced ARI NZALEZ s ��s%, 0 L (Signature o Notary P I G' •of F Wsion a GG 181686 (Signature of Nota Publ' A;$ Flor�tQe fiis on 9 GG 18168 c: My Comm.Expires Feb 1,2022 oF_ My Comm.Expires Feb 1,2022 Commission No.� ondedthro �� tionalNotaryAssn. Commission No. I eondedthr tionalNotary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 1/9/2019