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HomeMy WebLinkAboutBuilding Permit Application All APPLICA LE INFO MUST BE�ICOMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1-1 Permit Number: I �✓ ©� �, - �� RECEIVED �r r Building Permit Applicati n F`B Z 5 2019 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 PERMIT TYPE: COR Address: -35-06 Ayt f'YI Property Tax ID#: z q 0<—(-a as--05—ooo-- � Lot No. Site Plan Name: Block No. Project Name: a C 4~ QTR CTIt 3` (�lEC7RIVtyIf:�N: ` - , ; Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters; _WindoWs/Doors Electric _Plumbing _Sprinklers _Generator _'Rood:: ����.�a_.;Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 23 SO Utilities: —Sewer _Septic Building Height: SLL®• RSSlx 1 ew Name IQ kess Eden k Name: Address:_ 3�-O G Alye /77 Company: City: State: Address: Zip Code: ;!Yffi 7 Fax: City: "State: hone No. 6153 Zip Code: Fax: E-Mail: 1auaawd'e/S"01iC/0ud.. c olr) 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. - 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 pemrriitto,.dothe wo.rk'arid 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 OB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR ER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' SIgnature of Owner/Le e/Contractdr as Agent for Owner Signature of Contractor/License Holder STATE-OF FLORIDA STATE OF FLORIDA COUNTY OF X_%) COUNTY OF The forgoing instr�tmentt was acknowledged before me The forgoing instrument was acknowledged before me this day of Y-� 20 1 bythis day of 20_ by CS e 6S Name of person making statement. Name of person making statement. Personally Known' OR Produced Identification Personally Known OR Produced Identification Type of Identif cation Type of Identification Produced 1-Z p Produced (Signature of Nota (Signature of Notary Public-State of Florida) . arts:•.•• DEANPIAMARIEGNENS = MY CQM� �Q�#GG 022023 Commission No.(r EXpiREecAfitber1s,202o Commission No. (Seal) Bonded Ttw Notary Public UndenAters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.