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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Num � f _m TV? RECEA ED RE - JAN 2 8 2020 Building Permit Appl cation Planning and Development Services Permitting Department Building and Code Regulation Division St. L�Icie County,, .L 2300 Virginia Avenue,Fort Pierce FL 34982 yr Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: I�Fc>e5 oc-j'>9 4; PROPOSED DMP OVEMEN LOCA I� N: Address: Property Tax ID#: / 3 6>1 – O/ ' 3 – Doo – l Lot No. 3 Site Plan Name: Block No. Project Name: DE AULE► DE-�SC•R+kPTION O WOR�K: 5/V Al s To `Ot)�Z &UefOD 4P.Zy O-'Je 1aye2 c�� SA moi/i n�/e �l r�d� le,7;9' / CONSTRUCTION tNFOR,M,4TION: Additional work to be performed under this permit–check all that apply. Mechanical _Gas Tank —Gas Piping _Shutters _Wind'ows/Doors Electric _Plumbing Sprinklers _Generator Roof �2- Pitch,' Total Sq. Ft of Construction; �� 7 r# Sq. Ft. of First Floor: Cost of Construction:$ fl• 1] Utilities: —Sewer —Septic Building Height: W070 R_R,7%1 USSR, , I CONTRACTOR: Name /2�UL O�U �1 Name: Address: 70/ _5Z' /aa11 alpg �i /� r-s- -Company::.:.., City: PSC. State: { � `Add'r'ess:`' -'- Zip Code: Fax: .City , State: Phone No. 7 7 2- �?f -O-Y,57 Code:c.; -- Fax: p E-Mail: 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 CONSTRUCTf©N LIEN LAW i�NFORMATIO 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 4kTTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 62�' I " - - . . Signature of Owner/Less ee/Co ntractR r as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF COUNTY OF The forgging iinsJP4Tent was acknowledged before me The forgoing instrument was acknowledged before me thi day of,--),.,,, 2 ll 06 l7 by this day of 20_ by 4-v Name of person making statement. Name of person making statement. Personally KRPWR OR Produced Identification Personally Known OR Produced Identification Type of Identificati n r- _ n Type of Identification Produced UY 'e 1 C Produced (Signature ofo ary Public-S ature of Notary Public-State of Florida) i , AUDREY B.HUMPH Commission No. .*:(5MYtOMMISSIONOW gQo ission No. (Seal) "a �= EXPIRES:March 6,202 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19