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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: fi 1 q Permit Number: RECEIVED a� Building Permit Appli atC ' ' ion OCT 1 1 2019 Planning.and Development Services Pe r173 itti n L e pe rtrTll e nt Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 J LU I ®LI nty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial PERMIT TYPE: Address: - Property Tax ID#: 57 U,3— 0 © © Y 7 S Lot No. Site Plan Name: Block No. Project Name: D SC«R P O • ' K: oe C� Addition work to be performed under this permit—check all that apply: echanical _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:$ 0 b Utilities: —Sewer —Septic Building Height: N Name L' Name: Address: Company: ' City: State:_ Address:: Zip Code: F x: City: =State: Phone No. Zip Code: Fax: E-Mail: Phone N6 ' 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. SUPPLEMENTAL CONSTRUCTION HEN UAI W INFC?RMATI -o 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 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 COMMENC ENT MUST BE RECORDED AND POSTED 011 .TH J B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND OBTAIN FINANCING, CONSULT WITH YOUR LEND O AN ATTORNEY BEFORE RECORDING YOUR NOTICE O COMMENCEMENT." S'gn�,u aof wrier/Lessee/Contractor as Agent for Owner Signatue` of�C rittractor/License Holder STATE OF FLORIDA _ ST E OF FLORIDA COUb"OF C U�OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20by this A day of 204, by Name of person making statement. Name of person making statement. Personally o n OR Produced Identification Personally wn OR Produced Identification Type of Identific 'o Type of Ide tific ion Produced `(� Produced , (Signature of Not r Public-State of Florida`) (Signature of Noth Public-State of Florida ) Z�PV P(B. �. 'pYP'. Commission N ;o• y�: AUDREYB.HIQ���I�EY Commission N ;<a...u''•., AUDREYB,HUf� �' MISSION#GG 300817 MY COMMISSION GG 300817 EXPIRES:March 6,2023 Bonded ru Notary Public Unc erwriters Bon ed Thru Nota Pubic Und rNriters 0a;IWAasw+cua.+�saa�r s�,u. t Notary REVIEWS FRONT ZONING VISOR PLANS VE�ETATf i" ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/19