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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tt Date: \ 8A\:1 Permit Number: . . RE 'EIVED Building Permit Applicatio ®fir Planning and Development Services .�;.� Building and Code Regulation Division ST. Lucie Coun 2300 Virginia Avenue,Fort Pierce FL 34982 County, ermitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSED fiM'RROVEMEN L© ATItON: Address: SIL 5-A,W, Property Tax ID#: Lot No. Site Plan Name: (� I� 5 Block No. Project Name: DE AIL/E�D D ASC�RfiPTtON OF WORK: l �� p -60 X-671i�r- L 04,2 CO STRUCTtON I'NFORMATfiON: 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: -7z Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer _Septic Building Height: OWN11@1 l-�S�SE CONTRACTOR: Name g�2Snti, &JA1i1t1� Name: 6 gni (_vr/f 2y� �i� Address: Z4 6� fn, �f Company: o i✓ �1 o �SD�tJ City:��, i9, State� Address: Zip Coded�/ Fax: City: � y� /1i1 � State: Phone No 22�P�2T ���� Zip Code:'.. 9 /v . Fax: E-Mail: Phone No bFv,Z, —14o Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) State or County License �"1 � 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. SUMENERML Camra CTION UM UNY NM ATION: 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 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 Y UR LENDER Q_R A ORNEY BEFORE RECORDING YOU"OTICE OFCOMMENCEMENT." Signatu aof caner/L Contractor as Agent for Owner Sig na of Contrac icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 'S k. COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20XI by this,1 day of 20A by Name of person making statement. Name of person making statement. k .- . Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification' Produced rr Produced (Signature of Notary blit-State of Florida) . >:; (Signature of N a:::: l#ac—,Sta> � JjIVE 5 ;i NAMARIEGNENS ir' ce MY COMMISSION GG 0?1023 Commission No.-_(�6 ? ,; M( s19N#GG 022023 Commission No. PIRES:Decem 16,d901210 dIS 2020 i; Thti Notary PUbR !ln:riters +c •�*= EXPIRES:December Public Unde writers REVIEWS FRONT ING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v. 2/7/19