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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: I �I I ° Permit Number: I '"-I. — _, ..:..... u-_..w .......= Building Permit A plicate �tfnent Planning and Development Services ' ` C-y eye' ! Fk- Building and Code Regulation Division peva`'°'-"t c(Jung ° 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial e�sidential ! PERMIT TYPE: PROPOSED I.MPROUEMENT LO,CAT.IONf Address: n&Q l �— Property Tax ID#: ��J��a —�C� 1 ©o z4o oho LA Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK CONSTRUCTION'INFORMATION: 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:$ 71 ASO •® tom Utilities: —Sewer _Septic Building Height: OWNER/.LESSEE r =- _ri,1 Y{ CQNTRACTQRT .� r m m. Name ccw Rc"rAAO. Q Name: - Address: Z) — Company: L City::Eac t- State:`moi_ Address: Zip Code: 3140' Fax: City: c StaterC, Phone No. Zip Code: --'S!AQ Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail Lc�c3��ar�IecFt-I�c ,�6 ��•Ca from the Owner listed above) State or County License-zq-2-1 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 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 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 3#E JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEN OBTAIN FINANCING, CONSULT WITH Y0UW_L,4NDER OR AN ATTOR BEFORE RECORDING YOUR NO OF OMMENCEMENT." Z t e Own /Lessee/ tractor as Agent for Owner Signatu f on ctor/L" ense Hold ATE OF FLORIDA STATE OF FLORID!&�- The COUNTY OF COUNTY OF forgoing instr e t was acknowledged before me The forgoing instrument was acknowledge efore me this day of 20M by this mAVday of AZ ttl ,20by ��1N�t rz �iCSs ed A/6L�1?� deGGs Name of person making statement. Name of person making statement. Personally KnOR Produced Identification Personally Known OR Produced Identification Type of Iden "ficatio Type of Ide ifi n Produced Produced (Signature of -� EY (Signature of N a Public-State of Florida { YP�e�.,: AUDREY B.H Commission ;�`� � P,tYCOMMISSION#rr����G 0817 � EXPiRES:March'E;i3 Commission No. �;UDREY B. �� ' EY -."T •• ': =* MY COMMISSION O GG 300817 '.`cnF c,�• Bonded Thru Notary Public Underwriters 9,:. tia:, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE �FfL� �� ra T r ota PublieJndenvriters VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.