Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: BQJO QQC3� Building Permit Application 7tannin7an�Developrnent Services iBullding and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: 772)462-1578 Commercial Residential (/ PERMIT TYPE: wt PROPOSED tNtPROVEMfNT LOCATtO Address: 'Z00 7j it/(.v P-61 FC0m-_A . C r Property Tax ID#: �� - � � �� dd U- Lot No. Site Plan Name: ��- `�'L . , Ply �y� ��� Uw'��I Block No. P'oject Name: S�t�e S 11 � �I y,L� t� off- T99-2-No DETAILED DE�SC �tPTION O'F WORK: I C(7NSTRUCTION INFORMATION: i l Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters P""W indows/Doors Electric —Plumbing _Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: i st of Construction:$ �00 4>v Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRA: TOR: Name 0 e Name: s ��✓ �e Q Address: . �a (! ;t '` Company: City: � C�" � ��' • �-� ''• State:_ Address,- Zip Code: =Fax: City:, �r� . - ii° i State: L- Phone No.-.'- , .!.:--',.,• a: ;. Zip Code 3YS8 3 .r,. + -.Fax (4 E-Mail: Phone No,r �Z Fill in fee simple Title Holder on next page ( if different E-Mail /�°�Q �'O q u-� P !fL Co 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. SUPPLEMENTAL CONSTRUCTI©N LIEN LAW 1NFOR{MATPON: DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: _ of Applicable Name: Name: Alddress: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ of Applicable BONDING COMPANY: _ of 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. Stl 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 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 WIT OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF 4MMENCEMENT." I 1 Ilk 'Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY COUNTY OF 1_12-1 OF , The forgoing instru nt was acknowledged before me ;The forgoing instrument was acknowledged before me this day of 20� by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Dim o �,"hh J[P' (Signature of Notary Publi State of Florida (S at re of Notary Public tate of Florida) Commission No zoiCr'4o`c; LASHAHNAINGRAM•RAHMING Commission No. FiAHNAI I.Rp�IMINGtAS a*• *__ MY COMMISSION#GG275060 rats gP' MY COMMISSION#GG 275060 'a;; EXPIRES:Dewmber*20,2022 '•''e ;o?` Pu ticunlmry ers REVIEWS R PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19