No preview available
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:�q Permit Number: HaE--::E� LMN Jaw RECEIVED MCI Building Permit Application SEP 2 6 r019 Planning and Development Services Building and Code Regulation Division ST. Lucie Coun Permitting , 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: - PROPB.SED IMPROVEMENT L• ATIO Address: 77 Property Tax ID#: �a`-a�� as -o a�- a ao- a Lot No. Site Plan Name: Block No. Project Name: ©ETAILF�D DE8SCRIPTI19N ONFIA WORK: J C s�-�.r Zgda_ dsgd CONSTR{UCTL• N IN!F©RMATlON: Additional wo to be performed under this permit-check all that apply: _Mec nical _Gas Tank —Gas Piping _Shutters _Windows/Doors E ctric _Plumb//ing _Sprinklers _Generator _Ro PitcH' Total Sq. Ft of Construction: C� Sq. Ft. of First Floor: ,5L/� _ Cost of Construction: $ Utilities: —Sewer _Septic Building Height: OWNER/L� S CONTRACTOR: Name Name: Address: Z Company,- " y City: l`P_/G Stater ddress:" Jul -I Zip Code: rJ L� G Fax: City: n Sta e: Phone No. — 3414-7 Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title 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. 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 AFFIDAVIT: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 thepermit 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 JO SITE RL51170RE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDIE R AjAiTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 1 1 Signatu of O er/.Less /Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID� STATE OF FLORIDA COUNTY OF 3 LUc vol COUNTY OF The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me this-'**Co day of 20 by this day of_ 20_ by tial► •n e. Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica ' n Type of Identification'- Produced dentification'-Produced L- Produced (Signature of Notary Pub f Flo ' gjMM� �t�6,2 �,s t(Signature of Notary Public-State of Florida) Commission No.(Z]i�d�' "= go N Commission No. (Seal), REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE, MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19