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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: % ' 0, RECEIVED F. _ Building Permit Applicat on FEB 2'6 2019 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 St. LuciqCounty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi ldentmal PERMITTYPE: 10,TJu P' OPOSED IMPROVEMENTLOCATION: Address: 511L _(.-1 CE' �a Property Tax ID#: b v1 ' �Q. I/ C? l0� ' ©© (�' 0 Lot No. Site Plan Name: ,,�� Block No. Project Name: ILt�/� P—KV CA, gtf:;6=.S. ©ETAILED ©ES.ORI,PTION OF WORK: CON5T aU"019 I 'FORM TI•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 _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ ` n� 0 Utilities: _Sewer _Septic. Building'Height: OWNER/LE�S�SEECONTRACTOR: Name Lt :Mou Name: Address: �5 ()6 1 ' 1 Company: e,�,fir.. UL V►1n1 r)4 . City: r�i ,'�<Gt�C-(�i State:M7 Address: Q Zip Code: ,`aye Fax: City: ' - �if6�� Stat Phone Nof��rl � —�� -�r����C� Zip Code:V-5 Fax: t E-Mail: -)CA/A 0�)J � a-. t -Joe-+ Phone No X7,2 ,,,Id—&Q2a Fill in fee simple Title Holder on next page (if different E-Mail �l from the Owner listed above) State or County Licensee r L 14,1 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. SU °P'LEMENTAL CONSTRt1CTl©N 1�IEt� LAW UN;Ffl'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 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 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.kul) 1 N d W I o Signature of Owner/Lessee/Con ractor as Agen f-rwjE Signature of Contractor/License Holder Ua STATE OF FLORID m STATE OF FLORIDA COUNTY OF Z COUNTY OF pa F Q X� The forgoing instru nt was acknowledged bef re ' g The forgoing instrument was acknowledged before me this day of .b 20,Q b m this day of 20_ by r!/ _ ,Y4 Name of person making statemen W'=s" Name of person making statement: Personally Known . OR Produced Identification Pefsonally Known OR Produced Identification Type of I tion Type of Identification Produced Produced 1A A— (Signature of N ry Public-State of FloridY) (Signature of Notary Public-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 7 T_I