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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:22% SIM "04 MOVED n COUNTY KM6%0 • R I k Building Permit Ap Iicatic ?P 6 2017FL Planning and Development Services Building and Code Regulation Division Permitting De' 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commerdal t!es n►tnalCo PERMIT TYPE: M(� L),-)� y-) JCa- C) MJr DD 9NW_o)MNWOA ION: Address: �- Property Tax ID#: 3 3 / Sy e O - 06 U '- g Lot No. Site Plan Name: Block No. Project Name: D AW DNO,111 PUT1ION ©f OR c;. �� t� i a-�. l �s�,�. - S �w '���� - J `��--� 1 U 'rte-✓ @MMUE RM Eff Qq,W,TION• 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. F#'of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Syd Utilities:.. _. ..Sewer _Septic Building Height: O jLE�SS~E Cs0 RA � R: Name /� I A /-Zk n Name: D 5 Address:-/C7 Q Company:/9AIII L. C A city;.�,/ SUS P_ State:�� Address: 10 ��I,��FInn Zip Code:_l S / oZ b Fax: City: L State: Phone No. 2 7�2_ c;21f. Zip Code: tZ f Fax:" E-Mail: _ Phone No ,� /� Zo Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License G >I 7 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. SUPPLEMENTAL CONSTRUCTION LIEN LAU1l 11 -1 ATi t 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature o 0 n r/Lessee/Contractor as Agent fo Signature of Contr ctor/License Holder STATE OF FLORID�4 W STATE OF FLORIDA W COUNTY OF m COUNTY OF n 0 D C C The forgoing instru t was acknowledge efore ' M V.r_r, The fo fgoin Yinstru�ent wds acknowledge,bey re ? m r�'„ thisda of�! 20 b LQ W thisda ofol��� 20/_x/ b �' v, 03 Name o person aking statement. N �, m Name of rson aking statement. N = < rya m� Personally Known OR Produced Identificat(p� �+ Personally Known OR Produced Identificati Type of Identification n) � ::; Type of Identifi ati �) Produced (�Y D Produced (S ture pf Not ry Publ'_ tat o F orida) (Signatu e f N r Publi of F or' a_) Commission No. a) Commission REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.