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HomeMy WebLinkAboutBuilding Permit Applicationa .— SUPPLEMEN'CONSTRUCTI;ON1 EN LA;W INFORMATION EN,,-'T. '. . . - DESIGNER/ENGINEER: _ Not Applicable Name: Address: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 WIVU vni1n 1 CRInED nn AN ATTnnNFv RFFnnF DFf ARfIING Yniip NATirF nF rnmmFNCFMFNT_" Sig a e of Owner/ Lessee/Contractor as Agent for Owner Sign o Contracto Lice se Holder STATE FLORIDA STATE OF FLORIDA , COUNTY OF COUNTY OF The f r oing instrument was acknowledg before me by The forgoing instrument was acknowledged before me this Aaday 201�_ by tl i day of 20� of n 1C1 vv. }N�(tiQ Name of person making statement. Name of per on making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced S' na re of Notary Public- St a of Florida) ignature of li State of Florida ) No. rg..yAL� : LASHAHNA INGRAM-Commission Commission; COMMISSION# GG 27506C _a; ISSION#GG275060 '.;FaF :: EXPIRES: Dece LUHMING .•off REVIEWS I ecem er d ublic 2' �';P'ER : SOR w .. PLANS "-- VEGETATION ru Notary f'ubllc S GROVE COUNTER REVIEW REVI W REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED tcev. L/ // 17 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED CIj Date: 1161 I nI Permit Number: 0 Building Permit Application 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 Residential PERMIT TYPE: �eCY►LG PROPOSED IIVIPROVEMENA,T LOCATION: Address: oaLso8 - Property Tax ID #: a_H0_-Q - t0()S_Mcc Site Plan Name: Project Name: Lot No. Block No. In DETAILED DESCRIPTION OF WORK' RP,p>i-� Iae4 riser wire weaer-hai m�-�kr r G,ONST:RUCTION, INFORMATION o 4 Additional work to be performed under this permit - check all that apply: _Mec anical _Gas Tank _Gas Piping _Shutters _Windows/Doors lectric _ Plumbing _ Sprinklers Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �,©� Utilities: —Sewer —Septic Building Height: OWNER/LESSEE:: CONTRACTOR: ` µ Name �1 1 _ Name: 1'` e3 r O Ll- Address: $- f-4- Or, Company: �� 1 _ City: c=t. l�erC2� State F1 Zip Code: Fax: �i Phone No. Address: 1010V4 H180,a City: pA . +C 1Gi( � State: t , Zip Code: N -- Fax: _A(GI"11t'9�5 Phone No 0 1 —1K3a E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail ad X OM li- State or County License L I Q(�� 0 to Li 3 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.