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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date ` (IN ! �. Permit Number: ' REC71VED Building Permit Application JUN Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial _ yll� Residential PERMITTYPE: 1000 SED 1'MPROMEMEN L� CATION: Address: J 0 Qs_ ', G Property Tax ID#: 1' OV Lot No. Site Plan Name: Block No. Project Name: DETAILED DMMION OF W©RK: _ IQ � )ccs CONSTRUCTION INFORM TION: 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:$ a�y Utilities: _Sewer _Septic Building Height: O ER/LESSEE; CONTRACTOR• Name cS Name: 1&_C Address: - �D cS; (�C nL L Company: Y�A'2 - C'ity� P.`(� 1., C ►`', State: Address: /��QL,se-2-Dr�C2� Zip Code:c�4'�7' Fax: > City:A,�P&4',da: T State: Phone•No -_•6:;M— :=02.29/ Zip Code Fax: E-Mail: Phone No��92�j]7 dI= Fill in fee simple Title Holder on next page(if different E-Mail ��{��r7�/�I from the Owner listed above) State or County License C aC: I ZI 797 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 CONSTRUCTION LIEN LAW 1!NFORMATfON: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Siture of Owner/Lessee/Contractor as Agent for Owner Signa re of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFCOUNTY OF Theorgoing instr ent was acknowledged before me The forgoing instr ent was acknowledge before me this j day of 20A_� by this J_�_day of 0 by �e I i Name of persdm4 making statement. Name of person rAaking statement. Personally Known OR Produced Identification _V/ Personally Known OR Produced Identification I/ Type of Identi4eatron Type of Identificat' Produced Produced (Signature of tMYf�iolic-$t8t(�ONF�riNA LSEN (Signature of Notary PublicREN S. NIELSEN State of Florida-Notary Public .`o��YAUa�', State of Florida-Notary Pu lid Commission N r- Commission I07484 Commission No. •_ Expires = �_ C45eed�sion # GG 207414 ' mmiss on xpires -9 P June 12, 2022 °, My Commission Expire ''''°in``� June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.