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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: S �(J✓ \ Permit Number: CFt1§1 4 _ Building Permit AppliLResien AR 2 0 2019 Planning and Development Services [,fn Building and Code Regulation Division 9 et%zrime 2300 Virginia Avenue, Fort Pierce FL 34982 1e ilt Phone: (772)462-1553 Fax: (772)462-1578 Commercial nty, FL PERMIT TYPE: 111.0,SED fMPRO1/EMINT 07171MfiON: Address: . Property Tax ID#: `��d�— to / 0 r/.=:t cD /' Lot No. Site Plan Name: Block No. , Project Name: © ITNILEND DESCR+IPTI©N COF ORK: 1 («CONSTRUCTION INFORM�►T1©N: Additional work to be performed under this permit—check all th6t-6001y�� _Mechanical _Gas Tank _Gas Piping ij`" _;shutters Windows/Doors Electric Plumbing _Sprinklers tGen'.erator Roof, - Pitch Total Sq. Ft of Construction: Sq. Cost of Construction: Utilities: —Sewer _Septic Building Height: OWN tE�Rf LE�S�SE CO'NTfZACI OR: Name '—`m L_ o Name: Address: �� ��-� IC��I� Company: City: �O- H State: Address: Zip Code:3C, 01 i Z �zFax: City: State: Phone No�? l/�-/65-7c-J3 Zip Code: Fax: I'7 E-Mail: P WRAG 0 i\ 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. SUPPLEMENTAL C«ONSTRUCTI©N 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 ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNE ECORDING YOUR NOTICE OF COMMENCEMENT." T Signatur f Own(611 Lessee/ tractor as Age =) Signature of Contractor/License Holder 846 STATE OF FLORIDA [ill STATE OF FLORIDA L06 m COUNTY OF OF"QT C �� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged be this day of 20_ by -this W day of v i 0, C. 2019 b Name of person making statement. Name of prson aking stateme t. Personally Known OR Produced Identification Personally wn OR Produced Identification Type of Identification Produced Type of Identifi tion l Produced (Signature of Notary Public-State of Florida ) (Signature of Nott, ot Pu lic-State o F orida 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 Rev 2/7/19