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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE(INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �e t Date: �- -��,(- ( � Permit Number: d�d 1 � >4 RECEIVED Building Permit Application Planning and Development Services APR 12 2019 Building and Code Regulation Division ST. Lucie C n 2300 Virginia Avenue, Fort Pierce FL 34982 — trf pelf ilmno_ Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ ^- PERMITTYPE: F+S�© IM �R®VE�MEN L•C TION�� _ Address: 450 Pe-An ' /-aAe,- -/ teme Property Tax ID#: �� ,_ ��\� ����-` dc3(3 �0' Lot No. Site Plan Name: Block No. Project Name: D X41 E�© DE��:�':TION O. VtIOR�K: dod flritiva0v C0 s RucT�O . 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: O Cost of Construction:$ . ( , Utilities: —Sewer —Septic Building Height: OVtIIUER`I_ SSE CONTR C}R: Name Name: Address: Company: - City: r4 State.LL. Address: Zip Code: Fax: City: State: Phone No. Zip Code: Fax: E-Mail: 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. SUPPL MENTAL CONSTRUCTION LIEN LAW O MORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: 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 madeJto 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,lin 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 .,THE JQBBEFOR THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WIT LEN R ATTQRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ignature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY COUNTY OF OF 5)r. 1.15c, The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge before me this day of 20_ by thisday of 201 by 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 r Produced (Signature of Notary Public-State of Florida) (Signature of Notary Pu " -State of Florida .. 1 Commission No. (Seal) / �� •�=✓� �AR1�G1Vc 023 � Commission No.lsCs�l G�""� 1oN#QG6 2 20 JAI �S:QeceMb U�deNi�ilevs F�.p1R NotacYPublic . i TF61' REVIEWS FRON G SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTif REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19