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HomeMy WebLinkAboutBuilding Permit ApplicationII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � ®��� Date: �I `7 Permit Number.MMITIII 771=1 t �ZMNQC M RECEPT' Planning and Development Services Building and Code Regulation Division. 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 , Fax: (772) 462-1578 Building Permit Appli :ion JUL 2 4 2019 Permitting Department _ St. Lucie County, FL Commercial _Y-,, Residentia (Address: �,P A�` P f t-� C,1 � % 8I0/4, 6 112 3 �,� Property Tax /�l0��-l1 [ADO �- (°z�©g Lot No. Site Plan Name: Project Name: _ s7 DETAILED DESCRIPTION IF WORK: rU CoW'Vi .CONSTRUCTION INFORMATION: Additional work to,be performed under this permit- check all that apply: Block No. )v c„P t/ _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft,of Construction: Cost of Construction: $ ,OWNER/LESSEE: Name cS % 4 Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: CONTRACTOR: Address: hJ 3 b a Vj rq / n 4 N v -y G� City: r e rState: L Zip Code: 3 Fax: Phone No. 7 E-Mail: 6)Yidg111e- Q(z- 3 t"LUrI6C'0.O/Cj Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: G:AAgjr,-`r_ Company: A EL,fos�-1 Addres, City:T-17A\5�21CIGO" 5 State: G Zip Code: 2.OiSpFax: Phone No `�� 7 �j (P 3 % 7_ ? 3 E-Mail_ PAA3*i>> 6 `zs 'i_ f �iDL • �M State or County License_ P-7G _ 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. DESIGNE Name:_ Address:. City: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ ENGINEER: _ Not App State Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone:. Not Applicable BONDING COMPANY: Not Applicable Name: Address: City: 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. iIn 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 i"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." V(K)� 0 O� n Aignature of Contractor/License Holder Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA l STATE OF FLORIDA COUNTY OF COUNTY OF 4`, 0 > .�.� . The or oing inst ent was acknowledged before me � The forgoing instrument was acknowledged, before me i this day of k. �• 2QL by thisf�day of 20 � by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification NQ Type of Identification Type of Identification Produced Produced (Signature of Notary Public- State 8f Florida) (Signature of Notary LASHAHNAINGRAM RAHMING Commission No. 'o`•"`Y'``� = IASH/{B61dll)VGRAM_RAHMING Commission No.*= MYCOMMkGG275060 MY COMMISSION # GG 275060 ''FOF F�0 ° SIRES: December'20, 2022 oQ= _ 8onded7h '•.,�FF�••••• Bonded Thru NotzPublic s REVIEWS FRO PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19