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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��Ia�1 \`l Permit Number: RECEIVED ' OCT 21 �01� i' Building Permit Applicati . Lucie County, permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential i/ PERMIT TYPE: PROPOSED IMPROUE�M'3NT LOCATION: Address: Property Tax ID#:�L-kyo" 'SOS" Ci��`� C70U Lot No. Site Plan Name: Block No. Project Name: DETAILS© DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas'Piping _Shutters _Windows/Doors Electric _Plumbing- _Sprinklers _Generator V Roof '-Z, Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ `d I `y(�C) Uc� Utilities: —Sewer —Septic Building Height: OWNER/LElStiSEE: CONTRACTOR: Name I--, Name: v /L W' '0. Address: 5a',S ' l� �5 .\e.,nL Company: kA.i- _ �n City: State: Address: IS'J'S, �� Zip Code: �a��4�Z Fax: City:yar-Q '3­1� 1,U(_%-L_ State: Phone No. Zip Code:�"-LRQ I Fax: E-Mail: Phone No_J:J , Fill in fee simple Title Holder on next page(if different E-Mail��lbP� �✓� �ftiRs M^ from the Owner listed above) State or County License la n 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. PRA' ENTAL CO STR ON LI 1 0 A 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 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 W1fifi0'UR,LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 1 Signatbre of Owner/Lessee/Co tractor as Agent for Owner Signature of Contractor/License Hold STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5-�. 1. %3c- COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this-'4%\ day of GCt 2011 by this "JoA day of 20\`\ by Q%0\ c%—X W►\-9—y Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced `K- L'D'L Produced \R �-- (Signature of Notary blic-State of Florida) S nature of NotaryE pz3 S � \E�NEN 23 ' � Y MMISSION#GG6�2p Commission No.�Gcsa-o.a�.'� t1A y#G�6 Z?Comission N g;D ��.Mdti1s C)VIS mbet d At 1,, ?� ;a. d�NotaY FUD" P1�' vc i ••. MY S.D pC�cDn ::� oc`; Bonde REVIEWS FRONT e0+ed ISOR PLANS VE G11 I' ION SEA TURTLE MANGROVE COUNTER '' REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19