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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTL�� Date: Permit N �-� 120'19Building Permit ApDepartmentPlanning and Development ServicesBuilding and Code Regulation Division COUnty FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: o O PROPOSED IMPROVEMENT LOCATION. Address: n0i i& Property Tax ID#: ©y � [)I)— o �-- V — Lot No.' Site Plan Name: Block No. Project Name: ��L fL� }7 Y ! r DETAILED DESCRIPTION OF WORK: ,e- A e le T—/, 45-c, 2 - 12, 22e"o CONSTRUCTION INFORMATION: 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: $ 10 0 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name C ,fir CA' Name: Address: Company: City: fU!9 ! -e.1Ze, L State: G Address: Zip Code: .7 Fax: City: State: Phone No. 77 ,fS /�icf 07 Zip Code: Fax: E-Mail: /&U1 7 /,' (P e;lviAf/ 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. SUPPLEMENTAL CONSTRUCTION LIENi'.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,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." Signa ure of Ow /Lessee/Contractor s Agent for Owner Signature of Contractor/License Holder STATE OF FLORID - STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instr nt was acknowledgW-by before me The forgoing instrument was acknowledged before me this day of e 20this day of 20_ by b2.i / Name of person making statement. ( Name of person making statement. Personal) nown OR Produced Identification / Personally Known OR Produced Identification Type of Idents •onType of Identification Produced / Produced (Signature of N o ary Public-State f (Signature of Notary Public-State of Florida) =o��s.Pu"B" AUDREY B.HUMPHREY Commission No. : . MY.d6M*S10N#GG300817 Commission No. (Seal) : yr ,AR EXPIRES:March 6,2Q23 ••.Fo s+4• n d Thru Nota Public Underwriters REVIEWS FRONT ZONING SUPERVISOR" PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.2/7/19