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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE jjINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:��z/n Permit Number:Iqun I`I Building Permit Application Planning and'DevelopmentServices , Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 7- PERMITTYPE: PRO-POSED IMRROVEMENT LOCATION: Address: �F01 Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: ,�vrc¢- ID ERNA:111 @ 01 DESSCR,I'PTIONeF WORK: r PTzncL JC, y�CZ &cis CONSTRUCTION IINFOR,MA ION: I Additional work to be performed under this permit-check all that apply: i _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors I Electric _Plumbing _Sprinklers _Generator _Roof Pitch. Total Sq. Ft of Construction: ��� G.'near Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: r OWN'fR/1E-SSE CONTRACTOR: :Name � w-� er�•rw.r�- Name: 'Address: Cexse� Company: City: State: VL Address:_�:z� -<..•,:. �I' ci. . i:tFLf�c:.`rl ��,.L,.-_ .' Zip Code: ��q;Z Fax: City: .i " ti `' ''.5r. f'? State: jPhone No. -7-7 2- -(eW-K, Zip Co'de M :�.'>V:�'; ;; Fax-,'i. (; �s1� � ;�a.�c-cam P E-Mail: hone-Nb' 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. SUPPLEMENTAL C©NSTRUCTION LIEN LAW INFORMATION: 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 O T OB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOU ENDE OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signat of Owneessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY COUNTY OF OF Vu"_,Q The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this `day of 1N\,Qry*,),_ 20 19by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced V3__ (Signature of Notary Public-State of Florida ) (Signature of Notary Public-S to of Florida) Commission No. (Seal) Commission No. WERREVIEW — MING ION#GG 275060 REVIEWSFOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19