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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE/INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )(� ,n Date: C©a�Gq Permit Number: (% 119 - 0 J &QCEIVED Building Permit Appl Planning and Development Services Building and Code Regulation Division 0 C T 21 2019 2300 Virginia Avenue,Fort Pierce FL 34982 g pa rtrrl ent Phone: (772)462-1553 Fax: (772)462-1578 Commercial egrpg� FL PERMIT TYPE: Ac,_ k&1e14 PRO-POSED IMPROVEMENT LOCATION: "p Address: l M S JP/M-f, � 7 Property Tax ID#: X` O L- V55T3 '0Q10'•- Lot No. Site Plan Name:NeAn Block No. Project Name: DETAILED DESCRIPTION OF WORK: L , .t ~ '7�n/� ' CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: V 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:$ Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Z,` , - Name: Address: 79 f 65 Company: ° H& City- State:�L Addres Si✓ wS T: Zip Code: 3 Fax: City: State: Phone No. ,J30r-�Kl 933'3 Zip Code: �'`T Fax: E-Mail: &Td Phone Nol . W Fill in fee simple Title Holder on next page (if different E-Mail r tej- e from the Owner listed above) State or County License_ Ct'�/�y�b 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 LIEN LAW INFORMATION: . 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' I Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF - The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this `off I day of /Q�-1-• 20� by this day of 2014 by (Wer J 1fr . Name df person making statement. Name of erson making statement. Personally Known OR Produced Identification / Personally Known OR Produced Identification Type of Ide ific o Type of Id ti ation Produced �. Produced (Signature of N ry Publi - (Signature of N ry Public-State of Flori ...vu`, AUDREY B.HUMPIi E 0817 * "__` P EY Commission :;Q 9°: MMISSIONtf(�g�a3 Commission No. :��PYPgbG,. AUDREYB. 22U0�2 MY COMM 00817 EXPIRES:I last o + _ :+: d 7htu Notary �b�« tS�ti7 , EXPIRES:March 6,2023 �: ..i _. Fad 1tU p. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE�'VTOI'�f"`�'§IfATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 9