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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dater Permit Number: A qG RFc��F � s 1 _ Building Permit Application <��9.0 1;e' Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial ResidentialJL_ PERMITTYPE: Ku C FROP©SED IMPR{OUENT ME10-00ATI©IS, WE : 1111111 Address: ..L -ZN— � /�f �/ Property Tax ID#: �U �/ �D���-®�// / Lot No. Site Plan Name: (?yPRrsS' H1140,1_4 G Block No. Project Name: i DETAILED ORMPMR OF WORK: /0L,07- po hogb : 03 NNITIMISNIM20MTION: 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:-13 Sq. Ft. of First Floor: Cost of Construction: $ > Utilities: _Sewer _Septic Building Height. OWNER/LE�S�SE�: CONTR CTOR: me 6C� VtiL L . Name �. �-iw Ad ress�:" �(� �(� Company: Y �Ul� 1 l /LCG� G- '" State:/% - Address: Zi Code: Fax: City: P one No. ���.:' Zip Code: G111QlT WIFR : f 3d4d7 E- I: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License I 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. i Y -r SUPPLEMENTAL C«©NSTRU ION LIEN LAW INFt!)RMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: P ne Zip: FEE SIMPLE T LE HOL ER: Not Applicable BONDING CO PANY: 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 TWICEF R IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTE ON THE JOB SIT BEFORE THE FIRST INSPECTION. IF YOU INTE D T BTAIN FINANCING, CONSULT WITH Y U LENDER OR ATT RNEY BEFORE RECORDING YO NOTIC OF MENCEMENT." Sign atur O nLess Contra or as Agent for Owner Sign o o for/License Holder STATE OF FLORIDA STATE OF FLORID&, COUNTY r p COUNTY OF The for",g instrument was acknowledged efore me The forgoing instrument was acknowledbefore me this 0 gray of 11A 120 this day of 2 by C Name of person making st teme Name of person maki&statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced �� Type of Identification Produced —(Signature of Nota ;R� ' �` G; of Florida ) e o ` w [��o °f F� on No. o • Sra F� Seal (Signa' r I ' Vo a Nl1/ ''�i�iii���` o °f�F/1' }}++�� r V ryp Commissio fVA r -ITA x oc de�22 Fxp� 9/`C Ma°,� ? ooGyjV e d22 ss robs�SSi CG �l A REVIEWS t� AFRONT ZONING SUPERVISOR PLAN VEGETATION SEA TU 20? SM,NGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW EVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19