Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST'BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� r Date: Permit Number: I"{ 4 .V Building Permit Application Planning and,Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential f PERMIT TYPE: PROPOSED I'MPRUVEMENT LOCATION. ddress: C`� t/-�J�t(1 C�� e 7 rope rty Tax ID#: Lot No. Site Plan Name: Block No. Project Name: DETAILED QE�SGRIPTION OF ORK: 4, CQNSTRUCTION INFQRMATIQN: 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:$ 4000 Utilities: —Sewer —Septic Building Height: 009NER/LESS I CONTRACTO9.R: 111111111 Name (n<< Name: Address: a 3 C7 3 4'1f vw=e S. Company: City: }- �;C rcf, State: Address Zip Code:: OI 7 Fax: City: 9`{ �a ,d�oi"s2i-i c:,u+ State: Phone No. 6co 61 Zi6 Code:,,. E-Mail: rU,/ytwlidl bre�f �� ray �,«� 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. SUPPLEMENTAL CQNSTRUCTI©NUM EN 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 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 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 ITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENPfiVORfAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signa ure of Owner/LgWecontractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF � �, , .p , . COUNTY OF The f rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this T day of 1\)�l 20a by this day of 20_ by 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 Produced (Si na ure of Notary Pu ic-State of Florid (Signature of Notary Public-State of Florida) c f. Commission No. LASHAHNg27 5060 Commission No. (Seal) MY CMM OISSIQ # IRKS:December 20,= F; BoWed ThN Notary REVIEWS Ff11 UPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.