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HomeMy WebLinkAboutBuilding Permit Application All APPLI ABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:19 I fR�CEIUED -� Building Permit Applicatio NOV o 8 .2019 Planning and Development Services ST. Lucie County, Per-mit). Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PRC?POSED ! P .OUEMENT L(�7CATION° Address: 03 Property Tax ID#: I �� I��I �,�1T�' ©© '� Lot No. Site Plan Name: Block No. Project Name: DET ILEO DE�SCRIFTIO OF WORK: 4 11�­ 11—e— OCA I CONSTRUCTION I'�Nf-ORMATIWS 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: Sq. Ft. of First Floor: Cost of Construction: $ ��� o Utilities: _Sewer _Septic Building Height: OW ER 1E-89@ I JWRMTIMC=31.R: Name } Name: Address: Company: City: Stater +Address: -" - - Zip Code: Fax: ,L Gity: State: Phone No. – 3d "i Zip Code: Fax: E-Mail: Phone No- _ Fill in fee simple Title Holder on next 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. 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 AFFIDAVIT: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 l will, in all res.pects,­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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signa re ofcaner essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA _ STATE OF FLORIDA COUNTY OF COUNTY OF The fq{�going instru e w s acknowledge before me The forgoing instrument was acknowledged before me this T day of 204 by this day of 20_ by e) >� Name of perso making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifiati n Type of Identification Produced V. Produced (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida ) Commission No. "l'd�a.,, K(tp S. NIELSEN Commission No. (Seal), v: `�sState of lorida-Notary Public a Commission # GG 207484 0 Jube 12, 2022 REVIEWS FRON J PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED �e_v. 2/7/19