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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: :2.o toED JL6 -a i • 1pN�3 -®� Building Permit Application artme�ti .' Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT TYPE: PRWPWSED IM 01/EMENT LOCATION: Address: 5ao5 Soy1R 11\1 f) ) RN Riolzrl DO Fa} Property Tax ID#: O 17 0 2 O o d 2 a aQ );7 Lot No. _ Site Plan Name: Block No. Project Name: DETAILEDpDRCRIPTION OF WORK: u A] w-A Traily i`J P ji- R. e Q o T6 1-4 o szy a tv d71 P)-, I'S i IR,,i .5L r, vr,�) r ly Z"� 0 rl lg j, r,Ivo IML 1.W w U 1 S1�L @ 0,N-SITI R I UN INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas*Tank —Gas Piping _Shutters _Windows/Doors Electric )C Plumbing _Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost'of Construction:$ O o , ab Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name n 1zJ1 a-;r.' J/z SSS y Name: a �,i�Y) J T io y Address: So69 Sa U5-).j 1.(I(Digiy fDirtm 10h Company: City: ro )T State:l_ Address: $o0 5 S v i 11 11y/L� 2l vile �n Zip Code: >Y Z Fax: City:F6� 91rwen =.State:FL I Phone No. �7 �� S / o o Zip Code: 3q$ R ?. Fax: E-Mail: /V Phone No l72g-r S. a 6 6: 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. ,r S,U 'PLEMENTAL CONSTRl1CT1©N LIEN LAW 1'NF RMATION: 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 thepermit 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." Signature of 0 ner/Le e/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Sk LU r-=e COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_!�Dby this day of 20_ by W2 a Name of person making staterriefit. Name of person making statement. Personally Known OR Produced Identification r Personally Known OR Produced Identification Type of Identification Type of Identification Produced y L Produced (Signature of Notary Pub ic-Stat4 of Florida) (Signature of Notary Public-State of Florida) Commission No. Commission No. (Seal) �P011114 ELLEN VAUGHN of Florida-Notary Public *_ commission r y3F REVIEWS �' Y Sion Y22 p` R OR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.