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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO-MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tt U Date: Permit Number: . l. - RECEIVED . Building Permit Applica ion APR 04 2019 Planning and Development Services ST. Lucie County, Permittlnl Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462=1578 Commercial Residential PERMITTYPE: el_qe- PROP©SED i'MPRtO�(EMENT!©CATION: Address: Z 3 OLV `( Property Tax ID#: a+ �aa ' �'d2" ��53 dd0 Lot No. Site Plan Name: Block No. Project Name: DETAIilED DE�SC�Rd�TION OF WORK: u d\r-C CO 4 TRUCTION INFORMATION: 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:$ 16 0 o 0 Utilities: —Sewer —Septic Building Height: OWNER/LESS�SEE: CONTRACTOR: Name .� 71r11Y1 Name: Address:3111)q 'Wnyl-ke Company: • _ City--F '" )-er(e State: Address: Zip Code: 3q9 3Z Fax: City: State: Phone No.'_44 Z- -3 53 8Z Z-8 Zip Code: Fax:- E-Mail: qua I is QSUr i 0 0 n 4G 00 ,C 0 nn _ 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 CONSTRUCTION LIEN LAW tNFURMATION: 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." Signa ur of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY COUNTY OF OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by . this ti_day of 20%1 by `Pt `►^ �a ( Q ov,\v4q -@,Z 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 Iden 'fication Produced I43'S�cjfi�' (Signature of Notary Public-State of Florida ) (Signature of Notary P 44 U 11 106 Commission No. Seal •ir:;:ye••, AMARIEGIVENS ) ?� MY COMMISSION#GG 022023 Commission No." EXP4k?Mliecember16,2020 Bonded ThruNotary Public Undenvrters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19