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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE C MPLETED FOR APPLICATION TO BE ACCEPTED Date: YJ �i �, Permit Number: RECEIVED OCT 2 9 n39 _ Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: I r PROP©,�E�D IMPR©UE�MENT LOCATION: Address: Property Tax ID#:_ )`" �L'O3-J V 11 U � .�J r r Lot No. Site Plan Name: Block No. Project Name: Mom DE59RdP7ION OT WORK: d,01 cL lo� CONSAT]RBUCT(ON 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 _Roof Pitch Total Sq. Ft of Construction:2l'D 6 Sq. Ft. of First Floor: Cost of Construction:$���(q— Utilities: _Sewer _Septic Building Height: OWNER LESSEE: CONTRACTOR: Name U LAVName: � X , i::u i_uAddress: � _= _ pany: Z,S City: 1Dd Ci �-�l{U State: Address: Zip Code- Fax:. City: [� ' State: Phone No. Zip Code: GS Fax: E-Mail: �"� �l .CGC2SS�'f'I "r, Phone N(�o 7Fill in fee simple Title Holder on next page E-Mail W , , l from the Owner listed above) State or County License QJW1 VMI J 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. CO ST' U IO EN A 0 • 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 thepermit 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 POSFEll ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOY INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTO NEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signatu o wner/Lessee/Contractor as Agent for Owner Signature o ontractor/License HoldtK STATE OF FLORIDA STATE OF FLORIDA COUNTY OF—S L N_%)-VP, COUNTY OF 6},L.s c� The forgoing instrument was acknowledgelAbefore me The forgoing instrument was acknowled ed before me � this 14day of 0 'h 20_ by this "� day of d �� ,20� - by r�'\ d\ \'Q tz ` 1� 5 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 L. 1 Produced 1- t l (Signature of Notary liriliWl�,� D M,_OJEG1uE4 023 t'$ignature of Nota Public-State of Florida) CObe Gfi 1^0 RIVCommission No.CsCrG�a ;*= � IF December No. DEANNArg%I11ENS dedThruNotaN YCWASyI_0N# GO?207? ,���FOFF��•� B0° =,• EXPIRES:December 16,2020 •O� '•,FOFnq.• Banded ru Notary Pill lic Underwn;t:. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED iev. 2/7/19