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HomeMy WebLinkAboutBuilding Permit Application i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Diate: Permit Number: 1 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 PERMIT TYPE: R•WEND IN'PROUEMEN LOCA INN: Address: �3® eu�� N�,r 16, S'� L ti ea e ,�1— 3 r2 —Rrl pertyTax ID#: '�L C — '�2© T O o 15 — go®'d Lot No.� Site Plan Name: Block No. 3.' Pri ject Name: DETAILS© D��CIt PTION OF V1lQRK: CONSTRU -ION IiNFO'R�MA ION: 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: H Sq. Ft.of First Floor: 1 Z//7 Cost of Construction: $ 1 �Q_O Utilities: _Sewer _Septic Building Height: i ERf L .SSE CONTRACTOR: Name ;t2 -S-LcjnmvJsk , Name: Address: 2-30 6&vt/,w )�r Company: :City: State:f2- r.,`Address-.-- Zip Code: `3�a�2 Fax: ¢' City, '``' :'-^�,, :;-,; - - State: Phone No. % 3 t \ o `� E-Mail: 7L°G•15k VE: - Cow 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. i i I SU'P ' LEIUIENTAL C�NST +Cl`CTICl LI N W l' 'OR+MATT 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: I 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 inspection. If you intend to obtain financing, consult with lender or an attorney before cnnimencing wor our Notice of Commencement. i I �O Sign at re of Owner L actor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrtnt wad acknowledged before me The forgoing instrument was acknowledged before me this day of f.-u 20_ by this day of 20_ by Name of person making statem nt. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Idegtifjca 'on Type of Identification Produced } Produced 1 ignat re of Notary Public-'State of Florida) (Signature of Notary Public-State of Florida) Commission No. FtAki7 Commission No. (Seal) " ., IASM1SSti �,2 PUW REVIEWS FRONT °?;, . FII1ded �'' - R PLANS VEGETATION SEA TURTLE MANGROVE COUNTE p REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED LLIRev. E PLETED 9/26/18