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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: ��f7I' Permit Number: ; 1 19 RECEIVED r E ��, rom, NOV 2 7:2019 19 Build a 'o Planning and Development Services P Building and Code Regulation Division r rn�nt 2300 Virginia Avenue,Fort Pierce FL 34982 L Phone: (772)4624553 Fax: (772)462-1578 Commercial Reside tla PERMIT APPLICATION FOR: Irae o n ✓ PROPOSED IN ROVEME T LOC++AT:f1 . _ eYC� Address: Y`rwiw FY n. _7 Legal Description: Lo �CW W — CAn I I-,' BLV, H5 LTJ [c2l Property Tax ID#: 1 01 1 — © Lot No. 75- Site Plan Name: . Block No.N Project Name: (Oyd . Setbacks Front Back: Right Side: Left Side:. DETA'LED DESCRIPTION OF 1t1lORK: n n sio hra a nrw nome 'n 0 �2C �aP CON5TRUCTIOIMU&M A ION: Additional,worKtobepertormedunder this permit—checK all that appy: _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: $ +I,b.op Utilities: —Sewer _Septic Building Height: OTs NER/LESS E: COTRA OR: Name ��� 5 I_C,, r VName: _ Address: + Yd en wq Company: City: f c Stater Address: Zip Code: I Fax: City: State: Phone No. Zip Code: Fax: E-Mail: Y U I _ l CI0(jH. CM Phone-No Fill in feesimple 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. A l0 DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip:' Phone Zip: Phone: FEESIMPLE 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 thepermit 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 Couhty 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. T ra v('� fid, Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF COUNTY F ORIDA STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day ofby this day of 20_ by Ifo V o� � (d Name of person making statement. Name of person making statement. Personally Known OR Produced Identification I// Personally Known OR Produced Identification Type of Identification �y Type of Identification Produced v' ' C• Produced (Signature of Notary lic-State of Florida) (Signature of Notary Public-State of Florida) Commission No. AUDREY PHREY Commission No. (Seal) MY COMMISSION 0 GG 300817 F o Bonded Thru No Publ c Underwriters • OF FLS.• REVIEWS OR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.