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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 142 © Permit Number: it _ RECENSID r Building Permit Application DEC 0. 6 2019 Planning and Development Services 5F. Lucie County,Building and Code Regulation Division Permittin g 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT TYPE: `\ Address: C4 cn k VC4 (' cc(. f_:O� V+ Property Tax ID#: 13 -'s-af—GQS--Y —(Too—0 Lot No. 9 Site Plan Name: S IV Iq I'd-S' K U74, 1, S' Block No. _ Project Name: P1 UC: 6C.eS u'"Wce- S' t� T 4 Additional work to be performed under this permit—check all that apply: _Mechanical: _Gas Tank _.Gas Piping —Shutters . — _Windows/Doors _Electric Plumbing _Sprinklers V _Generator _Roof Pitch Total Sq. Ft of Construction: ,3 Sq. Ft.of First Floor: Cost of Construction:$ LT Utilities: —Sewer _Septic Building Height: Name OI c,n-C. to -11!' Name: &t lr'c_i cc An .1 rai4er Address: 1 ? Company: Xivq Ccay ✓ Atcl tal City:�Ff­Vj &rState: FZ- Address: 3 el a c it Zip Code: Fax: City: Stater Phone No. ? Y3 6r— L Zip Code: ,3 Fax: ?22--Ylely `ST E-Mail: /j/� Phone No73 I ��II �^,�3 wl 1� Fill in fee simple Title Holder on next page(if different. E-Mail T��^ e L,Gd►� from the Owner listed above) State or Couqy License J� ` 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 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 andaccessory 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 UR]LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as'Agent for Owner Signature"of Contractor/License older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me this day of .20 b�y( this day of 20_ by Affaime of person making sta ement. Name of person making/statem t. ,Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced Y ( ignatur o Pu lic- of I ric a) Signat otary Pub' tate of F rid ) Commis tom€-htS. N I E LS cim; Kin (Seal) "11111i �Y P��i `20.0 State of Florida-Notary Public ,����� KAREN S. NIELSEN ��ParP�B, Public =9. Pc My Comm ssion Expires _: Commis ion # GG 207484 REVIE S�'' `'°FRONT�une 1 UPER I PLANSo �1J N3fi� SEA TURTLE MANGROVE REVI REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. t