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HomeMy WebLinkAboutBuilding Permit Application t All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ®1-2 �� Date.: Permit Number: I _ 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 V PERMIT TYPE: hR0 ' �SEQ INP QUEM�ENT LQCATION: Address: dress: �(�? RE EA;44 W Property Tax ID#:,s4 A •Slto -coca ow3 Lot No. Site Plan Name: Block No. Project Name: ©ETA�LED DESCRIP ION QF WORK: r- diced f0 Ursa-- up 6' Wood -Fencc- around mV home oil plc .5j-e and Q4 Ar, bac'A. 1 w;I��f.? a#,.s two o,i e�?c4 S►de 0-f 7q4r Acyse and OAA Gi4 Ake &'C-A. CONSTRUCTION INFOR KAATION: 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: S > � Sq. Ft. of First Floor: Cost of Construction:$ 00 Utilities: —Sewer _Septic Building Height: i OWNER/LESSEE: CONTRACTC? Name ChriS4io i Siye Name: Address: IM IV-P FSf.Ca /_AI Company: . City:, 11 /yci(, State:�Z- Address Zip Cotle ���r7"83;Et Fax fOt tt. '' � State: t i.', (:^i'; t ..i.t..r..�vt 1. .� .•n r ,!'p Phone_No:`-:T 'SaO 5,605 zip Code:: Fax`';' E Mail 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. SU P EMENTAL CONST=TIMNSJ&M=1N'FaRMATM, 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. �Xrg�'n�atolf Owner/Lessee/Co -ct�i for Owner S' natur Contractor/L nse Holder STATE OF FLORIDAL1 ATE OF FLORIDA COUNTY OF S:IC# Lie COUNTY OF � s— The orgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me this(' day of Y�C,QQ, 20 by this qday of 'rrWu'_� 20 f� by Csv. tnk U,6 - Name of person making statemen . Name of person making stateme . Personally Known OR Produced Identification �' Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced gnature of Notary Public- ate of Florida) (Signature of Notary Public State of Florida ) Commission No. , I'�► GRAM-BANNING Commission No. IASHAHN I -RAHMING r �'.* MY COMMISSION#GG 275060 eu,_, COMMISSION#GG 275060 mbeft =2 •��OFI Bonded TIvu• Publio� ZI•'•',�iVFF�C. REVIEWS FRO PLANS VEGETATQ '='' COUNTER REVIEW REVIEW REVIEW REVIEW' REVIEW REVIEW DATE RECEIVED E-T DATE COMPLETED lev. 9/26/18