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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2 /1, R_� Permit Number: RECEIVED DEC 1.1 1019 Building Permit Application Permitting Department Planning and Development Services St. Lucie County,. Building and Code Regulation Division . 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential v PERMITTYPE: RROPOSED PM'PROUEMENT LOCATION: Address: l� PropertyTax ID#: 4/` ,, 7—&-- 60 Z.—00 (,:�-Q — (�)OG — 6 Lot No. Site Plan Name: Block No. Project Name: D ALLED DESS*RdPTION OF WORK: 5�0_v OE 6 ( h2a C'S Ara 1406 C w� c, Id 6 CC?NSTR�UCTION 6NFOR�MATION: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator V Roof -- Pitch Total Sq.-Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ /?fib Utilities: —Sewer _Septic Building Height: O NHRjLESSE: CONTRACTOR: Name A 190 }� Name: U Address:!2 x,57 �.�_ ,(C 1�1�1/� Company: , . City:�,,����� /�• Stater Address: ,:> A Zip Code: Fax;. .. ` City: State: Phone No.TJ�'_ ..�/'q''_" �n Gl> !' Zip Code: _46 (S Fax: E-Mail: __._. , . , Phone No Z7�a6 r � �.�• . = Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License j 3 t lqo 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 CONSTRfflTlON LIEN LAW INPORMATI©N: 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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Sig ture of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF COUNTY OF ORIDAS,T�u �CJ STATE OF FL COUNTY OF ORIDAa— W The for oing instrume t was acknowledged before me The forgoing instrument was acknowledged before me this day of20 by this day of Oe—c— 20 by LA Name of person making statement. ,Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of ldentificat*Lon Type of Identification Produced Produced ,(Signature b i ate ofFlorida) (Signatur of Notary Public-State of Florida) L.Lt'NI VH,UC'�{�( """'�, EL:- :—N:V—AUGH � �COmm15510 1P 4e Stair- : iCOmm155 rpe I, ia ublica-Notary u li # CG 270079 y Commission #GG 270079. 160: 22, 2022 °"'���"�� Oc ober2.2 2022 REVIEW itl ERVIS0R PLANS ANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE hA RECEIVED DATE COMPLETED ev.