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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED I I Date: I Permit Number: PICA Ol lei ''COUNTY • R I r Building Permit Application Planning and Development Services Building and Code Regulation Division y. 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: PRE ' O- E IKMRMQRM, ENT OC T1 Address: L 99I-i Ll 22D4olm bi --D,4-I Pik-c 4-L 3 yCp �`{ Property Tax ID #: 143®• rim- CO21`©• 006s- Lot No. Site Plan Name: Block No. Project Name: !IAdditional 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 i j Total Sq. Ft of Construction: Sq. Ft. of First Floor: I � Cost of Construction: $ `� S� ` Utilities: —Sewer _Septic Building Height: NameM"4r�l��v.9 Address:11fir- (4oP1 c4 U4 City: j ;24 C' State: FL Zip Code: 3L/ c' C; Cc Fax: Phone No.-)7Z - 90!Z —7530 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: P-I S j1IC=� S Address:a j a 5 S City45;4 , f C- CC state:r(- Zip Code: Fax: Phone. No '-))2. ' YC6,- yeeOCi E-Mail State or County Licens 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. 5 P ' LEMENTAL C�O�NST: U ION LIEN WIN 'ORMATtQN: 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." t I Eu igna u o 0 ner/ Lessee Contr ctor as Agent for Owner Signature of Contractor/License Holder STATE FL RIDA. STATE OF FLORIDA COUNTY F COUNTY OF TheArgoing instru ent was acknowledge before me The forgoing instrument was acknowledged before me this-1 day of 20I'l by this day of 20_ by Name o�making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced V�,_,hok* Type of Identification Produced I (Signature of Notary Public- ate of Florida) (Signature of Notary Public- State of Florida ) Commission No. .r�-,�,,�5.^'� Commission No. (Seal) r, ;y:V^;.%g�• LASHAHNAINGRAM-RAHMING nAn REVIEWS ' . , ; ai�P' C EXPIRES: Dece y�,jy�,ar, p ber'20 2022 b,ld,� PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED ev.