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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO/IMUUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date :=I L 1 Permit Number: _ RECEIV>=a Building Permit Application NOV 0-7 ZOR Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROP©SED iMPROUEMENT LOCATIO Address: chi s /GL g-D C-1 T__ Property Tax ID#: ,I��41 � !>��'� (90L4, ©©d l Lot No. { Site Plan Name: /.''6Yy&0_ Block No. Project Name: D TAIL�► DE�S`t�R+l TIO QF WOR+K: CONSTRUCTIQN INFORMA ION: 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: 2-7(40"o Sq. Ft. of First Floor: Cost of Construction:$ `2 COD Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: ON _ _ CTRACTOR: Name _ Name: Address: Company.,! t; r!_1. City: e, State:. Address:-I, Zip Code:3 Fax: City: ' ~by`'iS''fate: Phone No. I Zip Code: '- _ _ Fax:.- E-Mail: 1 7 -C'�IfY1 Phone No Fill in fee simple Title 14Mer on ext page(if different E-Mail 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. SUPPLEMENTAL CO'NSTRUCTIO'N LIIEN !AW INF®'RMATIO DESIGNER/ENGINEER: • . Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIM PLtTITLE 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 restriffor 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 U R.OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Sign atu e of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA. COUNTY OF . I uoilu COUNTY OF Thefo going instrument was acknowledge before me The forgoing instrument was acknowledged before me this day of 20 by this day of 20_ by e5k, V_ ✓ d Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificati 9Type of Identification Produced A Produced ( ignature (Signature of Notary Public—State of Florida) PRI!,11" .KAREN S. NIEL EN Commissio AT ` ;State of Florida-No r ublic Commission No. • .(Seal) ` 'on # G6 W484 =9, ac My Commission Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION. SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19