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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: p11._F3 Zi720 Permit Num Lation r-�(u � RE"ED VED C Building Permit AppliPlanning and Development ServicesBuilding and Code Regulation Diwsion 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓ PERMITTYPE: Address: Z.z-%SN L4ZKm ST FOILT PIES - - FLC>iu�Q 3494(o Property Tax ID#: 1-¢ - (� �- ��- G120 ) p Lot No. Site Plan Name: Block No. Project Name: r • ' - r� 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: / 7 L/ Sq. Ft. of First Floor: Cost of Construction:'$ E FJ ©� Utilities: —Sewer _Septic Building Height: Name f✓l.-LiaTT' 40Lj-ASD jfL- Name: _ Address:221ft N 4znol,-5't City: rZOzi Pim State:. Address Zip Code: -14G4G Fax: t. City: ' State: Phone No. Z- 2.2� 1 ci�-(o Zi Code:`r: Fax: p E-Mail: I-101rn0rl q P.4r."L� .cf)tj 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. 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:Fooms 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." ew Signature of Owner/ essee/Contractor as gent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrynTTt was acknowledged before me The forgoing instrument was acknowledged before me this day of 20c2Ay this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Id fi ation Type of Identification Produced Produced (Signature of Not Publi (Signature of Notary Public-State.of.Florida ) AUDREYB.HUMPHREY Commission No. ''�S ': M1(&0N1t)AISSION#GIG 300817 omrriission No. (Seal) EXPIRES:March 6,2D23 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION. ." SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19