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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J- r Date: D -7�© G Permit Number: I 0 RECEIVED JUN 2 0 2019 Building Permit Application SE'Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,For Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: Address• tJ ,2ry // P r(r,- O Property Tax ID#: tL( 2 `,®�- { �0 " �L�d Lot No. Site Plan Name: Block No. Project Name: A Q- lar. 5C 11,1.rG/� ©C o S, , I-r '�S e s t s 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: IF [yO0-0y Sq. Ft. of First Floor: Cost of Construction:$ '90700 . @p Utilities: —Sewer , Septic Building Height: Name buym Name.- Address: ame:Address: Orf C o m p a n C_ c��Ge -7Je V$ L City: ! State: rL Address: $Z23'0 G­rcrtG nc-t Zip Code: .3y9S ( Fax: City: flo rf S Stater Phone No. Ak Zip Code: _`l'L(� Fax; 2 E-Mail: (> Phone No 72 - 21(- - 1 -3 7 rj (• Fill in fee simple Title Holder on next page(if different E-Mail STC ,(?r,, 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. 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 r 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 LE E N ATTORNEY BEFORE RECORDING YOUR NOTICE COM CEMENT." Signature rFLORIDA. STATE ner/Lessee/Contractor as Agent for Owner Signature of ntra r/License Holder STATE O . OF FLORIDA L COUNTY OF_ '1.— i 1(1 .I COUNTY OF The oing inst ment was acknowledge before me The fo oing instr ent was acknowledge before me this day of 2011 by this day of 20by Name of person making statement. / Name of person making statement. / Personally Known OR Produced Identification °' Personally Known OR Produced Identificationy Type of Identification Type of Identif' ' n Produced Produced • C � 'V { (Signature o - (Signature of No KAREN S. NIEL$EN Yp� KAREN S'. NIELSEN Commission c}'?°' "A�;-;State of Florida-4R Public Commission No. �`O`�11IIe��'sState of Florid Qry Public 'E Commission#GG 207484 __• *= ommission 207484 My Commission Ex ices ,F oeP�� My Commission Expires j OF it ` une 022 REVIEWS FKUN I ZMNIM VISOR PLANS VEG A I 11JIM S EATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.