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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �' r Permit Number: �. RECEIVED 'ft-mw + ` AUG 19 2020 Building Permit Application Planning and Development Services permitting Department Building and Code Regulation Division ,t, 6uele�csuFav 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential --'' PERMITTYPE: PRQPOSED IM-PR01/EIVINT LOC>aT1 NN Address:( ` OS Property Tax ID#:�v j V 'Z wo ^ Lot No. Site Plan Name:, ( �61�� Block No. Project Name: ETAILED DE�SC«RI�PTIQN O W©R�K: nv COWAS TRUCTIONlNPOR,MATtON: 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: Zkoo Sq. Ft. of First Floor: Cost of Construction:$ `: � Utilities: —Sewer _Septic Building Height: OW ER/LE�S�S+aE: CONTR CTOR. Name Name: Addrq&&: 0 Q'sWc Company: VI CitState:_ Addr Zip Code:31 D7Fax: City: = State: Phone No. Zip CoMde: Fax: '— o, E-Mail: Phone No I Fill in fee simple Title Holder on next page(if different E-Mail ` . 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. I 1 FAM! e o • 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 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 W YOUR LOVDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ` �-- COUNTY OF � The for ing instrument was acknowledged before me The for oing instrument was acknowledg before me this-qday of 20 JJ by this day of 20by lou= I Igk/-L-- E2)�X, r�_r( osifx Name of person making state ent. Name of person making statement' Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatio / � Type of IdentificatJ'jn Produced t:: l0 � Produced � ry�io fo (Signature of (Signature of Notary Public- tate of Florida) ;i"YP�B, ELLEN VAUGHN `o State of Florida %,12 Public Commission No. ,`"'r'P�/ ELLEN(ISAAJ)3HN Commission N �_ �= # x.``22 �, *: ission 70079 �^ ate of Florida-Notary Publicil =b, a My Commission Expires =• Commission # GG 270079 / ,OFf�O�� xpires 11 ` r 22, 2 REVIEWS FRONT ZONING SUPERVISOR PLANS VEG { E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED iev. 2/7/19