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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5 Cs\ Permit Number: RECEIVED : . MAY 0 9 2019 R - IMiii Building Permit Appli lipa county,Permitting Planning and Development Services _ Building and Code Regulation Division / 2300 Virginia Avenue,Fort Pierce FL 34982 (f Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential [PERMITTYPE: d► ��� PROPOSED IMRR01/EMENT LQCA IOIv: Address: �l v- r-4t-- O Property Tax ID#: a Lf 3 y — 333 —05 2D 1 —600 —9 Lot No. Site Plan Name: / Block No. Project Name: D TAILED DESC«R[PTION e FJ WORK: r -e CONSTRUCTION 1NFOR',MATION: 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: 030 Sq. Ft. of First Floor: Cost of Construction:$ A S Utilities: —Sewer _Septic Building Height: NO WE N 10 RM 111@8SE CONTRACTOR: NameY- AQAJ 4R<VZI , kO% '01V Name:V 191) 41 Address: ra tjlo .ale-* ► rgen ' �1 Company: d � City: AD,r� A C r1L, _ State:A - Address: ' Zip Code:-3L(Of 52 Fax: City: State: Phone No. � ����l �� Zip Code:s'7t-Iq J5�� Fax: E-Mail: Phone No r7�z — 9'yo 2- 6 Fill in fee simple Title Holder on next page(if different E-Mail L from the Owner listed above) State or County License U!2 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. VS—Wil NLEMENALUMS Ll UCTt©N IEN LAW INFORMATION: 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 thepermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws onand 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 BEFO E THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOU LENDER OR AN ATT EY BEFORE RECORDING YOU NOTICE OF COMMEN MENT." ti sign at caner Le see/Con ractor as Agent for Owner Anbfure of Contra for/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF '-'V- ucf,e COUNTY OF Sk.ttic�� Theforgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this`d day of mea 20 fN by this 0% day of WN" 20)!k by 'Nit ��V,-I-, Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced %Z�L C) Produced iF k, L (Signature of Notary Pu lic-State of Florida 45ignature of Notary Public-State of Florida) Commission Non�'ad e1NAMAi21EG1VEI5 ! NAM ''jE�FS +4 =o;ar;u cy MY Co ',4# s �`�Ctl-. mission No. Oc�, E � i°' °= MYCOMPJl1SSI N UO"e[ December rlte�s t c*: °H- EXPIRES:DeoemberAAN 16,2020 B U NotPN "rF ori Bonded ThN No Pry r u' onde ocF;, REVIEWS FRONT 9OR PLANS VEG TANGROVE COUNTER W REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.