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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q Date: Permit Number: - RECEIVrI) COUNTY Building Permit Application NOV o Planning and Development Services Building and Code Regulation Division ST. Lucie County, Pernutc,; 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: 3� szc A.t S7 3 11b Q, L PL -34501 8' Property Tax ID#: I '"I - ©� ��� - ©QQ ' S Lot No. Site Plan Name: Block No. Project Name: FDETAILED DESCRIPTION OF WORK. L P1AC E_=Sc l-,m`. _) OAA) AnJ of -WTU I'�1 g acv c'cP�. L1°kc. rRoi, tK� CONSTRUCTIO!4 INFORMATION 5.. '.'r„ St: ; ,,tfu .a i•; �n iz.,. Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors X Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq.Ft of Construction: / Sq.Ft.of First Floor: ' Cost of Construction:$ f i �d�� Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name ��� _ Name: 17th r. F_ 0,-300 1'QLD Address: )De 'Is Company: t/� r✓�I�C', QC A+C_ City: P.<'• (-. T--( State: Address: __�D43 sO AO" /re" ,l.. aA_ Zip Code: - Fax: City: State: r=(, Phone No. Zip Code: Fax: E-Mail: Phone No 'Z- 3 Z ) Fill in fee simple Title Holder on next page(if different E-Mail VV-v6L6q 0 Lle,Ime. 00 from the Owner listed above) State or County License CC 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. 4­ '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 Coun 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 A&PATORNEY BEFORE RECORDING YOUR NOTICE OF COM CEMENT:' Signature of Owne' ass ' actor as Agent for Owner Signature of Co o 0r older STATE OF FLORIDA- STATE OF FLORIDA COUNTY OF —4 I l COUNTY OF ---4 The forgoing instru ant was a knoWedged before me The forgoing instru ent was acknowledged before me this�day of �d �C 26 by this day of O V 264 by � r� �tO Na of p rson making sta ant. Name of perso making tement. Personally Known OR Produced Identification Personally Known R Produced Identification Type of Identif tion Type of Identification Produced Produced 1\ (Signature of Nota c-State of Florida 11 (Signature of Notary Pu c,�S ,of FloF R E S N I L LO JO E��FRESNILLO. �aState of Florida-Notary Public Commission No. 6 o�Fl�d y P Z - _ ,Com �p n# GG 272747 _State ida-Notar Public Commission Nolte My NIssion Expires =* •6 Commission #GG 272747 December 22, 2022 M Commission 'Expires. DQcem er ,22, 2022 REVIEWS FR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.