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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: IPermit Number: - - — - Building Permit Applicatic n RECEIVED Planning and Development Services DEC O 6 "Ol q Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 / ST. Lucie County., Permitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial ,/ ResiclLPERMI,TTYPE:OP,OSED;IMPROVEMENT,LOLATION. Address: leas) Iv U.T i: 34 cA Property Tax ID#: I� c)o t 00C) Q Lot No. Site Plan Name:, Block No. Project Name: DETAILED DESCRIPTIOIV.OF WORK: CONS'TRUCTI`ON FORIUTATION # ' >� 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: rr,, Sq. Ft. of First Floor: Cost of Construction: $ 3D V .� Utilities: _Sewer _Septic Building Height: O,WNEft/LESSEE, . ' i. ;. CO'NTRA'CTOR: ` Name T1ir o 8e r Name: `T-71AW 111'I/ZplAHI Address: Q5) — Company:&U/4(��'� PZ010(111E PVC— City: k,�P�errrL� Stater.r AddressAWS sty/ C�IS©R AVE Zip Code: 31-1 4�D Fax: ]1a City: P0(2T SMA'101a Stater Phone No. 1A UU_ k4osZip Code: _S49S3 Fax: E-Mail: ��Yl�\ >OAtoa`�1 •� Phone No 3531. ?3 -y Fill in fee simple'Title Hoider on next.page (f different E-Mail &Z1/t)/20V 6��, 4-15'r from the Owner listed above) State or County'License-CC p H 144,?�3 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, bylaw's 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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE RIF COMMENCERW!' Signaturd of Owner/Lessee/ tractor as Agent for Owner . Signatu of Contra' cense Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF �� -�J�\� COUNTY OF MtL LdCkQ The forgoing instrument was acknowledged before me The forgoing instrument we#acknowledged before me this 3114clay of C ember ,20 \9 by this ISL day of 20_11_ by Ti m �;AA Q MA J PAi 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 L 1 Ce Y\S.(�_ Produced �r-- (Signature of Notary Public-State oftAA mary ruerastaa a( to o. Notary Public-S aa�� cAin Campos �v aELINA KOSKI Commission No. �� �J� Y Comrtiis;ion G 2C%Wmis n No. i l� t �{jPublic,state of Floridpires 0210712023 �� rtlmission#GG 245129 My comm.expires Aug.2,202 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19