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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:� Permit Number: Building Permit Application A:RECEIVED R 2 o3 , ,gPlanning and Development ServicesBuilding and Code Regulation Division ST. LucCounty, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 ` Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT TYPE: PRO `(3SED IMP, 01lEMEN' L9CATIt3N Address: 3, ,00gC-_e Property Tax ID#: 3L,7_q Lot No.� Site Plan Name: Block No. Project Name: DET1 llE s QE-ase+ TPUT11ON of w©RK: ;1�S i,�1�- S c%Lr �7 c-��cLs E / p'�r-• �L. � 5��c�,c.� (rw-5�ZI��- � _ CO STR{E1CTIt NFC+3RMA 0,W. 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 Z 6`2_ Pitch Total Sq. Ft of Construction: Z S_bD Sq. Ft. of First Floor: Cost of Construction: $ ( �E („/-D- Utilities: —Sewer —Septic Building Height: o NEFt LE-��slcoNTRaCONI Name Name: Address: Company:���or�Es�,��r �sC� City: P S L_ State:JEL- Address: ,.3>2-1 S Zip Code: 5'7i Fax: City: ff:—t State.•=c,_ Phone No. &o, 9-33 k93/I Zip Code: Fax: E-Mail: Al 4- Phone No mat —9'O ` Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License CGG 7 C5 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. I UiF'PLl ;NT ESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: NotApplicable ame: Name: ddress: 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 RECORD D AND POSTED ON THE JOB SIT FORE THE FIRST INSPECTI I YOU INTEND TO OBTAIN FINANCI CONSULT WITH YOUR COME C R N ATTORNEY BEFORE REC I q R. NOTICE OF Si ure o Owner/Lessee/Contractor as Agent for Owner SignatureOofCon tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY COUNTY OF Vo C- Q OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this-� day of 4:5-k C•N 20_NA by thi�3 day of a!�C 20�1 byr<v� Cq S d� Name of person making statemen . Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of IdentifJ'�c.,ation Produced (Si nature of Nota.._ - ;;;•q „�.. D- 10 I�NNAMARIEGNEN (Signature of Not Public-State of Floridan ENS ION#GGozzgas MpR1EG� Co missioR`lVa � ember16,2 ea d c�7.a�L.d M�SSIONrG6,20 0 6°<<^ �' ben ed i hn�Notary Pubtie Unde�a��iter,. Commission No.�s �• '` (5 `PIRE9No rypubiwUnde 6tery ---- —i 6ondedShru � REVIEWS FRONT �_RNG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED