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HomeMy WebLinkAboutBuilding Permit Application i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ' Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 (Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: I PROPOSED IMPROVEMENT LOCATION:. Address: Property Tax ID#: / Lot No. Site Plan Name: Block No. Project Name: ©ETAILED © OF WOR+K: r � I CONSTRUCTION INFORMATION: i 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 TI tal Sq. Ft of Construction: Sq. Ft. of First Floor: CI st of Construction: $ Utilities: —Sewer _Septic Building Height: OWNER ONTRACTOR: 'Nam , Name: 0 Addre 1 Company: City: 1 \ State: Zip Code: Fax: i City: State: Phone No. 6 7..,C4C rvl___''ZT ;Code ",:oa.,,r _ ;� %a`' fax: E-Mail: Phone No '� �(p Q Fill in ere 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. i PPLEMENTAL CONSTRUCTION LICE LAW Il FORMATYON: DESIGNER/ENGINEER: ' Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: IFEE 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 JOB SI� BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT j WIT YOUR LENDER OR TTOR Y B FORE RECORDING YOUR NOTICE OF COMMENCEMENT." W &40 a ur of caner/Less Contractor as Agent f r Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY 11 COUNTY OF OF The forgoing instrument was acknowledged before me The for oing,instru ent was acknowledge before me this day of 20_ by this day of 20tL by Juwl�al'.Q L maL. Name of person making statement. Name of pers n making statement. Personally Known OR Produced Identification Personally Known �l OR Produced Identification Type of Identification Produced Type of Identification Produced I (Signature of Notary Public-State of Florida ) 04ig6afure of Notary l5ubliP State of Florida) mmission No. (Seal) Commission No. :' Y°; INGRAM•RAHMIN MISSION#GG 27506 EXPIRES:Dewmbeft 20 :+ Q••. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19 I