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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED % �J Date: Permit Number:. - - Building Permit Application FEB 0 7 2120 Planning and Development Services 4 Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: ,PROPOSEDIMPROVEMENT LOCATION: Address: �"�. 5� 1 �c�SZ-`� -•. ��N� 3u�� Property Tax ID#:4_\5tA- tea- O�`Z- ao� -'�, Lot No. Site Plan Name: Block No. Project Name: k'kw_L L�"Vdc�C DETAILED DESCRIPTION OF WORK: F CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical —Gas Tank —Gas Piping —Shutters _Windows Doors g p Electric Plumbing Sprinklers Generator Roof `J / Pitch — — — — Total Sq. Ft of Con tion: A �_f�©p Sq. Ft. of First Floor: �Eac­'C.3 Cost of Construction:$' Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 's-K- c-, ` Name:IZ��'b&S • �� Ad%essA1S. S Company:(?""s-_Z,�i�gCitSteState:_ Address: ` -� �H�T Zip Code���`�l Fax: City. �� State: Phone No. Zip Code: Fax: E-Mail: Phone No `s 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. Eh IR Mid AIM* E. DESIGNER ENGINEER: Not Applicable MORTGAGE C�OMPANY- Not Applicable Name: Name: Address: Address: City, State: City: i 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 per;init to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permi . St.Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subjectsUcture which is in conflict with any applicable Home Owners Association rules,bylaws or an covenants that may restrict or pro ibitsuch structure.Please consult with your Home Owners Association and review your deed#or 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 Coun6 Amendments. The following-building-permit applications are-exempt from undergoing a full concurr� ncy review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use I "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 C NCEMENT MUST BE RECORDED AND POS ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF O�I NEI:D To OBTAIN FoNANaNG, CONSULT CE W OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU210 CE OF COMMENCEMENT-7 1TnVUFe, e �Cesse_eC_ontractor as Agent for Owner Signa cittOWse Holder STATE 20_Rll,�DA STATE OF FL101DA pa,,, Palm Beach Palm Beach COUNTY OF COUNTY The forgoing instrument was acknowledged before me The forgoing instr;ment was acknowledged before me this 31 day of January of Janua 20 by 20 20 by this 31 day of i nua 20_/--U Anthony S Bono Anthony S Bo o Name of person making statement. Name of person m king statement. V/ Personally Known 0 OR Produced Identification Personally Known't Z OR Produced Identification Type of identification Type of identificatipn Produced Produce shm,tE- �k (Signa (sign - ComMISSION#GCommi G 9 Comm n W MYCOMMISSION#GG910270 mber 4.WI) EXPIRE&Sepliimlber 4.2d2ta I Bonded Thru N%Mryfy Public UROWNIS !Bonded Thru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED -DATE COMPLETED Rev.