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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST-BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� �� Permit Nu hor• 6310 RECEIVED APR 15 2019 ACAM-39 W_ r ounty, r�erm(tting Building Permit App ' r Planning and Development Services r' Building and Code Regulation Division j+* 2300 Virginia Avenue, Fort Pierce FL 34982 11 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PROPOSED IMPR+VE �" T L^CATION: Address: Property Tax ID#: . L� COD 7 Lot No. Site Plan Name: 0 `0 D/�6 Block No. Project Name: DETAILS© DE=OR+IPTION OF WORK: ' CONSTRUCTION A.0100,0111111 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:$ S Utilities: —Sewer —Septic Building Height: COWN' , ER/� E: CONTRALTO Nae % Name: Addi, w ci Company: City: / `ter State: Addr � Zip Code: Fax City: tState: Cly �< Phone No. � Zip Code: ax:,_. 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. SUPPLEMENTAL CONSTRUCTION LIE LAW INFQRMATION: DESIGNER/ENGINEER: _Not pplicable 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: Ph6 ee 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 J98,SITE BEFORE THE FIRST INSPECTION. IF OU INIJENP TO OBTAIN FINANCING, CONSULT H UR LEND A TTORNEY BEFORE RECORDIN R NO MENCEMENV' rATE e of Owner/ e/C ntracto as Agent for Owner Si ature of(Cntr ctor/ icense Ider OF FLORI A STATE OF I Y COUNTY OL.1ro� OF The for oing instrument was acknowledged before me The forgoing instrumentwas acknowleV 4! dge before me this day of a f V\ 204 by this day of Ck �' �� 20)A by Name of person making statement. Name of person making statement. Personally Known OR PrpduceedIdentification Personally Known OR Produced Identification Type of Identification Produced jQ Type of Identification, Produced (Signature oti.Fr vvB = CO MISSION#GG 022023 (Signature of Notary P ic-State of Flo ' Commissio _% 9 �cemberlr� l GNENS DEANNAMARI� 022023 •. Op' 13 ded ThN W-'y pub"r Undetwnt rs Commission No.�G „fie SION#.GG "•,; F;;,.•• MY RES. 1G,do EXP2020 IRES. publioUndeN+dten' Bonded ThN No1ar! REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19