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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST.BE COMPLETED FOR'APPLICATION TO BE ACCEPTED Date: Permit Number: =nermitting W 0 NO, Building Permit'Applicatio Planning and Development Services , Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 GOI71171erClal ReSId2I1t181 PERMITTYPE: P NO0 10111 MP. • M 1=ION. Address: �3� �4N O-Q/J Property Tax ID#: ©Q'11.� '� Lot No. Site Plan Name: �� ►,� Block No. Project Name: w)1 G _ '=11W, OR1 ._EAVA-LL ° 71 ew 14V kC11 Td cJ . l y la k.W COTICEN )NFORM )O 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. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ /21d Utilities: _Sewer _Septic Building Height: WN 8,7%00 s>? ' CONTI2 C C}R: Name rt JP– S Name: 5'a5,_- i9k Address: 3 3c9 O! �° 2a. ccs L , Company:` City: 4i Y V Stater& AddrPo" '02 Fl a% :(;e) a Zip Code: 3"�-Z Fax: City: ;'N►Oct N D .13eq `. Stater ;7 . Phone No. ! Zip Code:: 3: .b Fax.:..- .. ...:� E-Mail: lei o G .6IkVA. Phone No 7 9 a –0 3� Fill in fee simple itle 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. SllF'PLEM AL CONSTRl11'1 N L1 N LAW (NFfJRMA7iON: 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 peri iW*to`do.the wor6and1n'stallation 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 ff6bo LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." SiCit Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �. Lu[; (c COUNTY OF The r oing instr ent was acknowledge efore me The forgoing instrument was acknowledged before me this day of 20by this day of 20_ by Name of person making statem t. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identific, i Type of Identification Produced —L Produced Q* 11_11"�_ (Signature (Signature of Notary Public-State of Florida) KAREN S. NIEL EN 1P uB Commissio A7�°. `_State of Florida-No�a rxx�ppublic ion # G6"�67484 Commission No. (Seal) =. oS My Commission �Expires .1tine 12. nf REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19