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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^!. Date: , ~/ `A Permit Number:M. C . ,� l � RECEIVED Building Permit Application ocr o219 Planning and Development Services permitting De Building and Code Regulation Division St. Lucie Partment 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: Del* PROPOSED 1' PROtlE ENT LOCATION.// Address: O F �O S, Qu in 0/-. Azo Je4 16eOdi _ —791(71-7 Property Tax ID#: �. / 71-49 - 004d 7 - Lot No. 160 Site Plan Name: Vlia1 ��� Block No. Project Name: /Q / .� DETAI'LE© ©EhSCRIPTION OF WORK: 1__1)y7)0Jefi Y- ee�a7�&,q and -,e tv)4)va 1-11,22 5- M 00,Yh- ho),n e- G✓1 CONSTRUCTION dNFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors !I I Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: q/) Sq. Ft. of First Floor: W2 Cost of Construction:$ Utilities: [sewer _Septic Building Height: � f OWNURNME�SSEE: CONTRACTOR: Name .r7 P ei , 1ohz Peira ze-1a Name: utn i f Address: 6OQ IK�� Company: 4e) �q i�h !I�cg 11 G. %ham• City:_:: ,4g,l State: Address: �� ✓➢lam; Jae,14,7 ,,f Zip Code: ) 0 5 Fax:,, City: !:-.State: �'L• Phone No.'s' ' 27511 /`Z "31,25- :'. Zip Code:Jj,�957 Fax; ,P,3), E-Mail: Phone NoZ. 7 Fill in fee simple Title Holder on next page(if different E-Mail e2 cg M, A/7"P9 Ge/c1,/ozp, Gold 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. RIMPIRIME;M,RNAT020601NSTRUC 114 N L EN LAW INFQRMATIO 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 L ND R AN ATTORW BE ORE RECORDING YOUR NOTICE Of COMMENC ME ' c Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/ itfense Holder STATE OF FLORIDA STATE OF FLORIDA .l.L� p COUNTY OF COUNTY OF l� The forgoing instrument Wvas acknowledged before me The forgoing instrument was ac cnowlecl ed before me this day of- 20�by this day of 20� by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identificatio� — Type of Identificati n -� Type of Identification Produced d/ls Produced (Signature of No Public-State of Florid;, (Signature of Notary Public-State of Florida) ELLEN A�GHN Commission No.gi of Flori eR tary Public Commission No. a �, ELLEN-Lwx�S r HN mission # GG 270079 ;_� e'�_State of Florida-Notary Public Commission Expires =• * Commissio October 22, .�hoPP`oe°:� My Commission Expires REVIEWS OR PLANS VEG 4 VE COUNTER REVIEW REVIEW REVIEW RE IE DATE RECEIVED DATE COMPLETED iev. 2/7/19