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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `� ` 3 a Permit Number: -4-a�b 1- aq RECEIVED JAN .14 21720 J Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 1 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PRO ©SED IMPROVEMENT W-001O Address: (ycf Property Tax lD#: /.:21)1 b0_7 PO-71 6004 Lot No. r7 Site Plan Name: 4,4-�l c:DCi ?Xaa&—'?-Z4 Block No. f Project Name: • �,VIt C"-"L /I DETAILED 13ESSGR;IPTIUN OF W@RK: Af It CO STRUCTI'ON INFORM A-04- Additional TIOAdditional work to be performed under this permit-check all that apply: Mechanical _Gas Tank _Gas Piping; ;�,J ;_Shutters _Windows/Doors f_=;Electric _Plum_bing _Sprinklers ',, %,Generator Roof Pitch �TotT Sn�'Ffof'.Go nstruction: Sq.`Ft.''o#'Fi,rs#r;Floor ' tiCostf.Construcfigns$.�?71�0 Utilities: _Sewer., , Se9tic` �: Building Height: o O NER/LESSEE: MON TRA« OR: Name Q C, Name: `(n Address: aLjV 97© Company: City: - StateAddress: I l�- Zip Code: Fax: City: State: Phone No (cif `-1! Zip Code: aFax: E-Mail: I royC¢G) 5i-&(C i' SSeA4 Ddsearrn, one No !:)I-) Fill in fee simple Title Holder on next page(if differeko -Mail nS i G , from the Owner listed above) State or County License rzc i 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 RECO,,PED Notice of Commencement is required. SUP AL=M'E ' AL CONS RUCTION L LAW INFO ATION' DESIGNER/ENGINEER: No -pplicable 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 POSTEDPN THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YPUR LENDER OR_AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." gna re of Owe Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder ATE OF FLORIDA STATE OF FLORIDA COUNTY OF �T ,a COUNTY OF — The forgoing instrument was acknowledg-A before me The fo%oing instrument was acknowled-Fed before me this day of �y 20 y this I`t day of � �-� �-1 2(� by +� 1 - P� o`��666 ��--►- —��.�-:sem C.S Name of person makin statement: �\ S�sGG +3 a of person making statement. 6R Personally Known OR Produ I� ,J\`Gc�a�yy�Ltk� Personally Known OR Proddced Id Type of Identificationa°�oc�`'�,°� Type of Identification ���puBui,,i G `1 J Jb• pn ti3 Produced ,� � , t3` P Produced Q -A-n 'M �^ S• ley �•�� 'All (Signat re otary lic-State o rida) (Sig ause o.tAota Public-St Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW .DATE RECEIVED DATE COMPLETED ev.