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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:JI 1 1`.1 9 Permit Number: I -9 12; o &L* RECEIVED Building Permit Application DEC 16.2019 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PRQP�SED IMpR©VEM' NT LOCATION. ^ (� Address: rb Property Tax ID#:�,2Z• ©Z• Lot No. Site Plan Name: Block No. Project Name: l3EITAILED DESCRIPTION ®F W©'RK: GO STRUCTIO'N IN�FOR'M .TION: 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:$ © - -b3 Utilities: _Sewer _Septic Building Height: OUIGNER/LESSEE. CONTRACT Name �--.L� • .-2eq`'i ' Name: Address: mpariy: e t" City,: �•_ State: Address:,,. b,��L V'c� Zip Code: ��' Fax: '' City: -.State: cc !! Phone No._�-- "l= c .,�- "` t ,: Zip Code:..3 �Q("qj Fax: E-Mail: Phone No Fill in fee simple 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. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMEN AL CCNSTRUCTIO LF£N LAW IN 'ORMATiON: 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 Twill,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 WWrWUR LENDER OR AN ATTORNEY BEFORE RECO RDIN UR NOTICE OF COMMENCEMENT." )v� Signat a of Owner/Lessee/Con t s Agent for Owner 2TErO' F a of Contractor/Li der S TE OF FLORIDA FLORIDA OUNTY OF COUNTY OF The f�oing Inst ent was acknowledgey�before me The forgoing Inst ent was acknowledg before me this day of 20 by this day of 20 by �►- �n H�,t ( . L lie- Name of person making statement. Name of person making statement. Personally Known ✓ OR Produced Identification Personally Known, I OR Produced Identification Type of Identif' on Type of Identificati fl� Produced Produced (Sig at re of Notary ubli -'St to of Florida) (Signature of Nota P1 'P at111,ilp8q NIELSEN _State of Florida-Notar p " KAREN S. Commis y ublic Commission N RYPU'o NfJIf SEN Commission No. o: � I);G 207484 ;zTafe of Florida Notary Public ,,OFF�, N1y Cornmission Expires Commission # GG 207484 June 12, 2022 June 12, 202 REVIEWS IISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.