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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED q Date:`acb 1 \ Permit Number: 1°to$'d Sa RECEIVED Building Permit Application AUG 2 6 "J19 Planning and Development Services ST, Lucle County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: �I: a-� �i��- - �r��® •, ��,� . PRUROSRED 1'MPR.RZOMENT WOWAM%R. Address: (� r� �q� i Property Tax ID#: 24W-•� —10 /7,z a p`- Lot No. 516 Site Plan Name: // Block No. Project Name: Y- �c�.�/s�,45; QETAILED 2099 IPTM QF W©RK; !s .�l�C� S S C�aNSTR+UCTICIN I'NFORMATI�N: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank 4 —Gas Piping _Shutters _Windows/Doors Electric _Plumbing, q _Sprinklers _Generator Roof ,C� Pitch Total Sq. Ft of Construction: �_ L/� Sq. Ft. of First Floor: Cost of Construction:$ Z m Utilities: —Sewer —Septic' Building Height: OWNER/LESSEE: G©NTRACTC?R: Name Name: Address.: = Sf Ad _ss`City . ` �---:--c y Zip=Co.de: S b F,ax City:; "'Y ��,y�Li State: L Phone No. `'`' : .' Zp''Code:' _ Fax: E-Mail: Phone No 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. IName: PPNSTR+ (TORN L DN LAW INFO MATIU'ESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable 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 O THE JOB SITE BEF RE THE FIRST INSPECTION. IF YOU TEND TO OBTAIN FINANCING, CONSULT WIT YO L DER.OR AN ATT RNEY BEFORE RECORDING YCOR NqjtlCE Of COMM ENT." SZnaiMeP wne essee ontract as Agent for Owner Signatu o Contractor/Lice se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Sar. COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this lC_day`ofd O� 20"A by this 1rk day of 20_ft 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 Nota Public-State of Florida) (Signature of NotarV Public-State S� p2y023 E OZ3 D �SSION#GG6 202p Commission No. �GOaac>a-'�j D 8 0� mmission No." h _ lAY�1P �nder►m . REVIEWS FRONT (9" ERVISOR PLANS VEGETATI TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.