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HomeMy WebLinkAboutBuilding Permit ApplicationII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982. Phone: (772) 462-1553 Fax: (772) 462-1578 PERMITTYPE: Building Permit Application Commercial Residential v ddress: .5-033 6 014 i(iJ cam. pi Li eck , eVu.A Cae, rope rty Tax' ID #: ��I t • � • �� • ��� ite Plan Name: roject Name: i � C(+3'NSTftUCTiUN INFORM TlC)N: Additional work to be performed under this permit -check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Cost of Construction: $ a M I �� � Sq. Ft. of First Floor: Utilities: —Sewer —Septic Lot No.- Windows/Doors 10 Roof Pitch Building Height: ' NER LESS ?E:1100NTRA T= Name 0,1V' Name: pp Address:�f��Leel�.1%Q�J / j�_ Company: n3/D City: " s�1 e 4 r a- Zip Code&�q.�/ Fax: Phone Stater Address: ..e City:" 1 /f State -)EA - Zip Code` y_ Fax: Phone No E-Mail: ,. , Fill in fee si Title Holder on next pageg 'from the Owner listed above) diff&enP E-Mail r Q PO State or Co icense 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. UPPLE MONSOONONSTRUCTI© LI N INFO M TION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: 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 U INTEND TO OBTAIN FINANCING, CONSULT WIT*WUR LEF4DER OR AN ATTORNEY BEFORE RECORDING) NOTXE OF COjtWNCEMENT." /Co�ntr�actoras SiL of Owner/ Less gent f ner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA 1 COUNTY OF COUNTY OF The forgoing instrument was acknowledge6 before me The forgoing instru ent was acknowledged before me this day of .�c 20 i` 1 by this � day of SZQ 20n by Name 0person making statemeRt. Name f person making stateRent. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced ig ature of Notary Publ State of Florida (Signature of Notary Public- State of Florida ) Commission No. Commission No. (Seal) LASHAHNA INGRAM-RAHMING �'L-- k. f# GG 275060 F;, .�:' E PIRES: December10,2022 "'''�'`'rM'�HMING R�I�fIB(ajJ�� REVIEWS F, ,, . gon ea�@ryPubli OR PLANS VEGETATII''N:F 0 SA`T�A� cerr . REVIEW REVIEW :j •",::ftEF� hN --- DATE ervidters RECEIVED DATE COMPLETED Rev. 2/7/19