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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED Building Permit Applicatior FEB 112019 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 ✓ PERMITTYPE: �_oGL PROPOSED I�MP--7R�QI�EMEN LOCATC©i' , Address: o� Property Tax ID#: 13o I O A 6 �J 160,6 1e Lot No. Site Plan Name: Block No. Project Name: t7ETAILED DESCRIPTI©N OF W©RK: e o up, ame C©NIONI 1N'FOR,MATI(+ON; Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/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/LC©Nl"RACT®R: Name G Name: Address: , PC, kz_ Z4 Company: City: TL 4 &0'--d State:EA Address: Zip Code: 41Fax: City: State: •t Phone No. Zip Code: Fax: E-Mail: 60mati l Ei 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. SUPPLE ENTAL CC?N51' f CTI�N LI PN � ?RMAT 0N: 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 and1ristallation 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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signat a of Owner/Lessee/Contractor s Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF . LIz�,�F, COUNTY OF The forgoing instrume t was acknowledge before me The forgoing instrument was acknowledged before me this� day of 20_q by this day of 20_ by \JRmC-S A, C11 4� IY�'`0 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificcaaty'on Type of Identification Produced 1, Produced (Signature of Notary Publi Eloricl (Signature of Notary Public-State of Florida) ``iCAY PVg/i AR�N S. NIELSEN Commission No. ;:° Sta 4 lorida-Notary Publi ommission No. (Seal) •c Commission #GG 207484 My Commission Expires June 12, 2022 REVIEWS FRONT ZONING PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED "DATE COMPLETED Rev. 2/7/19