Loading...
HomeMy WebLinkAboutBuilding Permit Application 1 , All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q Date: �'�~ t � J Permit Number. r m�r RECEIVED JUN Building Permit ApplicatioFn 7 ,,pig Planning and Development Services ST. Lucie pounty, Permitting Building and Code Regulation Division _ g 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: < ►� �� P NIS"'.fi) tM'PROV�T LOCATIe Address: D 0 A4,eXc,,..drY'Y,-- �[� EA Property Tax ID#: 50 3 — C)3 Lot No. Site Plan Name: Block No. Project Name: DETAILED DE�SCRIPTfeN eF WORK: r YVr `�a �C✓ 3 p n.0� r�z GeNSTRUCTIeN t�NiFORMATfeN: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters -74 Windows/Doors Electric _Plumbing _Sprinklers _Generator Roof - Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ /0,QoQ Utilities: —Sewer —Septic Building Height: eV1MR/'LE-SSEE: ftNTRACTeR: Name u-\ ,el Name: iA, �L Acid ress:('b � kG��J�� ��✓� Company: lJ/Lc_ City: -t\- Stater Address: 161J3 _so r-A Zip Code: : fAoL`B z' Fax: City: Fo)'P4 - \5-� Iye-c.-y State: Phone No. ` Zip Code: 3--{,9.43-7 Fax: _ E-Mail: Phone NO-)-I, Fill in fee simple Title Holder on next page(if different E-Mail cSh e3 �� f bzs w from the Owner listed above) State or County License Q�Z'e . L1,16 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. -SI P EMENTAL CONSTR=UCTION LI N LAW INF©RMATION: 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 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 WI UR LENDER OR AN ATTORNEY BEFORE RECORDING XOPR NOTICE OF COMMENCEMENT." i Signature of Owner/Lessee/Contra ts Agent for Owner Signature of Contractor/Lic nse Holde STATE OF FLORIDA STATE OF FLOR DA COUNTYOF 65 -, L-5-0', COUNTY OF The forg oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this a.�) day of 20 A by thisa�day of 3 y r-— 20M by Name of person making state ent. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced 'Fu fl L— Produced c�G_;5 iAR,E GN�Ns 23 (Signature of Notary P lic-State of F nature of gr- ublic-S ° ? jN, E5:Der,cn xy d rsnter Oa '•: (GM 5 p'remb 1c �`r x: lR tlotzNPubGc Commission No.(�s ;moi (�p��E ilotaN�'u� mmission " REVIEWS FRONT NING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19