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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE F MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: i( 1 Permit Number_ 0 Building PP 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:(�c. I~t�' CA f PROPOSED IMPROVEMENT LOCATION: Address: I? qd2 ( L r-- r� -- Property Tax ID #: 50L) D r `1 U� Site Plan Name: Project Name: No. * No. I DETAILED DESCRIPTION OF WORK: .I 1 . D CL/!�t ! �oel�U "ir in to 4-J D [CONSTRUCTION INFORMATION: I 1 Additional work to be performed under this permit -check all that apply: _Mechanical `Gas Tank Gas Piping `Shutters Win ws/Doors ,zflectric Plumbing Sprinklers _ Generator _ Roof Pitch i otal Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ % 0 3:" Utilities. —Sewer —Septic Building eight: OWNER/LESSEE: CONTRACTOR.- Name - Address: Q r Company: City: � - _P; 'efx--e -- . State: -EL Zip Code: 5 14jr Fax:— -- N JAr Phone No. - - Address: LN(^ , 5 L r Or, , City: fie_ Zip Code: Sc? Fax: Phone No - E-Mai( 1�n4e i State or County License Stater 9 cow -_e E-Mail: I d3 u Fill in fee simple Title Holder on ext page (if different from the Owner listed above) vs nrurc, a rEr-4 tutu ntouce or Wrnmencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: Address: MORTGAGE COMPANY: _ N t Applicable Name: Address: City: State: Zip: Phone: City: State: Zip: phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable Narne: Address: City: Zip: Phone: Address: City: 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 inay apply. In consideration of the granting of this requested permit, 1 do hereby agree that I will, in all respects, perform t e 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 additi ns, 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 RESULf IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST E RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FI ANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENcEME r-" YZ _.. Signatu essee/Co as gent for ner Sig tur , ra _o /License Holder STA"�OF FLORIDA STA OF FLORIDA COUNTY OF c C COUNTY OF (, The for oing instrument was acknowledged before me The forgoing instrument was acknowledge I before me this day of f 6er . 20 14 by this day of _ jl9k �� 0 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identifi a Personally Known ✓ OR Produced l entificati p-- Typv. of Identification rq, a c. 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