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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7^,��- aQ Permit Number: CS -4533 RECEIVED Building Permit Applicat on JAN ;dao Planning and Development Services Building and Code Regulation Division ST, luC(�County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: ,, ,RMP+ ROVEM LQCATiiDN Address: Q9-71 R10Q P'9 A F+ lerae- FL 34CIR 1 PropertyTaxlD#: 4I� -��1'� -®0©� ®®0--7 Lot No. Site Plan Name: /l Block No. Project Name: \S¢., 0Q(1 �IL�i� DE�C �IPTIQN� H3RK: vv_ ire I -,-r C I c► r'1!5, g4-ce W_ Cha STRUCTI� NF©RM T t)N: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Wiridows/Doors, 92 Electric Plumbing _Sprinklers ..Generator -Roof -Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: „a Cost of Construction:$ Utilities: —Sewer —Septic . . Building Height: �NfRJLESSI* . C>l+�NTRAC �Q Name Name: Address:&R-7/1 ROQ,� S Pp Company: ' City:1-�! .�1 ,�a�cc- State:-FL Address: Zip Code:S40CI Fax: N City: State: Phone No. '2�o`Z-47 1 -a O -1 I-��5 Zip Code: Fax: E-Mail: 4.A I COM Phone No Fill in fee simple Title Holder on next page(if different E-Mail 7 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 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 andel covenants that mayrestrict 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 N THE`JOB SITE BEFORE THE'FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WIT NDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." - u Si re of Owner/Lesse Co ractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5 k . L v V% COUNTY OF' The forgoing instrument was acknowledkgbefore me The forgoing instrument was acknowledged before me this_?,Aday of SQv 20_ by 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 Identification Type of Identification Produced ` L Produced (Signature of Notary Pu, ori1NAM 023 SION#G�022 �(Signature of Notary Public-State of Florida) .oy?�� 's My COMMIS 16 2020 Commission No. ember' 6r0 KotzrypubV11UnderNntat^_ ommission No. (Seal) i. ..... Son& REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. _