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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ig- Permit Number: J - , REC'NE VE REC - - OCT 14 2919 DI Building Permit Applica ion Planning and Development Services Pert' itting IVEDepartment Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial. Residential PERMIT TYPE: p d Address: �r��, i`7� r✓1 c/ �Iy to. n ` Property Tax ID#: l� �- >�� -00 0- / Lot No. Site Plan Name: rr 1 Block No. Project Name: IN �' 0 "d f C2,-? r7` 0 rooh n mcm, OVIMD NMI TION. Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors c/ _Electric _Plumbing _Sprinklers _Generator _Roof � �. Pitch Total Sq. Ft of Construction: / 5- Sq. Ft. of First Floor: Cost of Construction:$ 3. DLD Utilities: —Sewer —Septic Building Height: O CTO' 7Name �j/�,,� �� GvfoSS Name: Address: 5-661'7 K I /ave Company: City:_x'r KeeC. State:� Address: Zip Code:3L-/o/ S) Fax: City: State: Phone No. `7!�2- 30 ~7 Zip Code: Fax:. E-Mail:h',- G ' co Phone No Fill in fee simp a 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 C*ONSTRI�CTI©N LIEN LAW IN�OftMAT ION: 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 clothe 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 1 i f' Signature her/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA _ STATE OF FLORIDA COUNTY OF COUNTY OF The forg ing instr ent was acknowledged before me The forgoing instrument was acknowledged before me this 17day of /' 20��by this day of 20_ by edew Name of per on making statement. Name of person making statement. Personally KnoW' OR Produced Identification Personally Known OR Produced Identification Type of Identificati n ^� Type of Identification Produced �L ' VL y C` - Produced (Signature of N ry Public-State of Florida (Signature of Notary Public-State of Florida ) •4�Y FV•. AUDREY�PH�U PHREY Commission No. ;_• COMMISSTON GG 300817 Commission No. (Seal) EXPIRES:March 6,2023- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v.