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HomeMy WebLinkAboutBuilding Permit applicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION INFER: Not Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: � Not Applicable Name: Address: City: - State., Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: UVVrkltK/ ]LtJN I HALtUR AFIFIOVIT: 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 permitwili 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 FAMLURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY_ A NOTICE OF COMMENCEMOff MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT 1" fFH YOUR -LENDER OR AN ATTORNEY BEFORE RECORnMr. YntlR arnTrrr nir tnrAm1 wirr:wV rr n r _ Signature of Owner/ Lessee/Contractor asAgentfor Owner STATE OF FLORIDA Signature of Co ractor/License Ider i COUNTY OF STATE OF FLORIDA �, _ vz` COUNTY OF ThUfo ng instrument,was acknowledged before me thy of _ ZO by The for ing instru ent vy s acknowledged. 6 fore me this da of <- ! � - ,/ A by / % Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced identification Type of Identification Type of Identification Produced Produced Signature of Notary ublic`44tftFlorida j Erik Ne R1©Qa ( ry Ehibfic- Florida S Lure of Notary S` } C4lnmission # G6101442 Commission No. - ISIreS'Y 4, 2421 „�� •, Ed Nemoga Commission No_ = Cisiorl GC101442 Bonded thra Aaron Notary s Expires: May 4, 2021 rll611i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rr�tr All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: Q72) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: 3,3 i-5`cZ'- Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: I CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: _Mechanical Gas Tank _ Gas Piping _ Shutters Electric Plumbing Sprinklers _ Generator Total Sq. Ft of Construction: I Cost of Construction: i� Sq. Ft. of First Floor: _ Utilities: —Sewer —Septic Windows/Doors Roof Pitch Building Height: OWNER/LESSEE: CONTRACTOR: Name o•Ac�� ;�Se�l1L Name: '�Oyvt Address: 1 e' �A\ . q Company: a ,�666 _ City: Po\ ' S"A'::w-� State: Zip Code: � _ Fax: Phone No. Address: V q GLO City: b C I - St Lo "_ State: . Zip Code: 3 If , - Fax: Phone No 1-2 77) CU/0 E-Mail: Fill in fee simple Title Holder on next page if different from the Owner listed above) E-Mail 6: ( C c� v� ''�{� �` 6voy State or County License C F1_C 1 Y12`l 0_2 c IT Value oT construction is SZSUU 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.