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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' )v! Permit Num --) R' V210'D ,E C"E Building Permit Application APR 3 ® 2019 Planning and Development Services Permitting D e p a rtt e n t- Building and Code Regulation Division St. Lucie Ceu �/® FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: , Ve Li, ROPOSED tMPR01/EMENT LOCATION: Address: i Cz Property Tax ID#: 0 1–DO` Lot No. Site Plan Name: eta 1e/10 Block;No. Project Name: DETAILED ©E�SC�R'PTtON OF WORK: CONSTI UR, ON ?N -ORMATION 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: 910 Sq. Ft. of First Floor: d Cost of Construction:$ 4�60 ` a Utilities: —Sewer —Septic Building Height: FROM NERjIES�SE ; CONTRACTC•}fi: Name Name: Address: / Company: j City: State: [ Address: 61A4 Zip Code: ;?RM Fax: City: e_ k Stater Phone No. Zip Code: Fax: E-Mail: Phone No 77Z-370--75- 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. SIJRPZEMENTAL C 'NSTRl1lCNL I ,N L�11U1/ UNFQRM"T10CTI DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: 5. 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 thepermit 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 YOLIR LENDER OR AN ATTORN FORE RECORDING YOU NOTICE OF COMMENCEMEJIT." Sig ature of Owner/ ee/ tra,ffas Agent for Owner Signature of Contrac ice Hol STATE OF FLORID `r STATE OF FLORIDA _ COUNTY OF N COUNTY OF N The forgoing instr ment was acknowledged before -5 ,The f rgoing instr nt was cknowledge of thiday o 20 .by s zg thi 0 day of 20 4)y m iri $ ui enn Name of person making statement. ¢ Name of person making statement. < Personally Known OR Produced Identificati .•�d"«"�•••. Personally Known -*"� OR Produced Identifi ti• *.t'o�•. Type of Identification ;V Type of Identification Produced ° Produced ,••.,. ; ••N�1 (Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida) 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.