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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c� u Date: if � �G( Permit Number: ` a L\" �� l RECEIVED Building Permit ApplicationAP Planning and Development Services R 15 2019 Building and Code Regulation Division t= L.��i�County, Permltkin� 2300 Virginia Avenue,.Fort Pierce FL 34982 .. _ .. Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: .-. _ PRQPtU�E© INF'RQUEMEN LOCATION: Address: 1.2 Z4 ,J Property Tax ID#: `1 �/� 2 — yG 2 '? Lot No. Site Plan Name: /n� Block No. Project Name: C� L4=^/j'z�!T does DET ILED DESC {1PTION ©F WC�R�K: 7e CONSTRUCTINNIN'Pliff fON: 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:$ /0(/b Utilities: —Sewer _Septic Building Height: OWNE ,LESSEE: WIN IT, G1R: Name / Ore G 12- / Name: Address: Company: City: L tr–eq- State Address: Zip Code: ?3 Y62 Fax: City: State: Phone No. 36 l a3 f -- 772 Zip Code: Fax: E-Mail: �o(�(,r9/z����U�c/S�� rocJt� Phone No Fill in fee simple.Title Holder on next page(if different E-Mail from the Owner listed above) (�^M hL,cam 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. Sl1,P EMEN L CONST.i CTION L'EN W IN�FQRIMAT!'ON. 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 jobsite before the first i ection. If you intend to obtain financing, consult with lender or an attorney before commencing rk or recording our Notice of Commencement. Sign r of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID �``� COUNTY FLORIDA COUNTY OF -s The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me this-a4 day of Q Q I'N\ 20 by this day of 20_ by Gar r� Name making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification ProducedProduced (Signature of Notary blic- yp , EANNA MARIE GIVENS §ignature of Notary Public-State of Florida ) MY COMMISSION#GG 02202 Commission No aaaU =x {"' (SeAPES:December 16;2020 1�mmission No. (Seal) Bonded l hru Notary Public Undenvril rs� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. 9/26/18