Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a d Date: �1� ��- Permit Number: RECEIVED Building Permit Application .iUN 18 ?019 Planning and Development Services Building and Code Regulation Division ST. tuEi�;GrnbY, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PRNPOSED I1MQ Q, AEMENT LOCATION; Address: b CxrC N Az �j ` A 9,C/C"P-- Property Tax ID#:��1 C7 "��3 1��-UCjb Lot No. Site Plan Name: Block No. Project Name: DETAILED DE&SRIPTI©N NF WORK: r .. 1l1 � C ✓ IN,N-SIM RUCTi0N I1NFOR{{MATIN' N: 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:$ 1/0r � Utilities: _Sewer _Septic Building Height: OWNER/LE�SSE C©NTRACTOR: /- ' Name /�- Name: la I Address: Company: city: �A State: Addre c173 _—)w Zip Code: Fax: City: Stater Phone No. Zip Code: 30cl7 Fax: E-Mail: Phone No 7`a 66 'iS S Fill in fee simple Title Holder on next page(if different E-Mail g_- 1r m( aq4e)6t eew"L from the Owner listed above) State or County License /`70 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. SUPPLEMENT LCONST UCTION LIE LAW INFO MATION. 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 a-nd 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 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 WIT!"M ,MLEfikDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ZJI. Vv Sig ature of Owner/Lessee/Contr ctor s Agent for Owner Signature of Contractor/Licen Holde STATE OF FLORIDA STATE OF FLORIDA , COUNTY OF ��". 1.0 c\`Z COUNTY OF 3�*, LU c� (k_OTS, The for oing instrument was acknowledged before me The for oing instrument was acknowledged before me k:�o —A this R day ofy�Q ,20\I by this day of 5V V� 20� by Name of person making stateme t. Name of person making statem nt. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identific ion Produced Produced (Signature of Notary Pu c-State of Florid ���ta� t� .00��0 (Si' ature of No =StateRfi ,,{�x#00022 DV\\ tGgiO� t 20 O '� a::Yoc••: MY GO 3 pmbet 16.202 tets i GOCj,,d can Ut�Je �CP1RE � Uo�etwr Commission No. oa a o�3 ••(SEM) c3.`�e b5c frrmission No. 3 NxOta($ PIR- P'� dTh �. e REVIEWS FRONT Q SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19