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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 v, ' , Permit Number: , II Y .1 _� �1=IVED Building Permit Applicatio NO`Y' 0 5 4'0?9 Planning and Development Services Building and Code Regulation Division ST. Lucie Coun Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PR+ 'O-S yp l(VI'PROVEM � T OCAT U . Address: SS S'7 Property Tax ID#: 3`A '"• 56\ " cU19�k — c>06 -�-I Lot No. Site Plan Name: Block No. Project Name: C►).�A��© D�SCRIPTItJN � WORK: OfC&V '1/11J L1(_r1-1 7��,J 1�� Lam► NSTRUCTC+0 1NFORMAT)ON; 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 Ritch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ LeA:�>25 Utilities: _Sewer J Septic Building Height: ODUNERJI_E�SSE CONTRACT a R. Name Name.'Pse> y25Z" Sro U0- Address:--7S3' G� $fid: Ste' C6mpa6y NCS W C=L-C_ city: r„2t: �'� ���:ii� State: l Address': :5M Nom' JNA, f2/� Zip Code': j:S'2 Fak City:q. �T �� LUCK State:,(= Ph6ne.No. �o'J:�-_ J 3��2 Zip E-Mail: 'J Phone No G t 15C 0,3 CO Fill in fee simple Title Holder on next page(if different E-Mail t� Gl/l>tIL_.. C eV 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. SU F'LEM ENTAL CONS 11GTl0 LIEN W N CRMA I R N: 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 POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTI U INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDI G YOUR NbTjCE OF COMMENCEMENT." Sign ture of Owner/Lessee/Contractor as Agent for Owner Sig ature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The f oing instrume t w s acknowledge before me The fo ing instru a was acknowledged efore me this day of 20. by this da of V 20�by a -V— td�'- - — . 'g r 764-;&� Nam of person making statement. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identi ' ion\\ Type of Identificati Produced LL Produceds�L (SignHu-Fe of Nota P,� . tate pf4� NIELSEN (Signature of Notar u�19+$ptate 9 NIELSEN °5 PU i% =°t State of FlorirJa-Notary Public =_ �cState of FIqrida- '' _ Commis LSI Commission No. :� q& a4 GG 207484 Commission No. =a '= Commiss G 207484c � y Commission Expiresorv�o My Commission Expires June 12, 2022 """ June-12 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE - COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.