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HomeMy WebLinkAboutBuilding Permit Application i I All APPLICABLE INFO Mn,US,T BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dater °/ ' G.�Q" ! ) Permit Number: i IRD COUNTY ., , 01:4 Building Permit Application j Planning and Development Services " Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: P flP05ED NtPROVE EN LOCA 1©N: Address: O �[ i '�[ Property Tax ID#: 13— 00D0' OUB Z9 Lot No. Site Plan Name: Block No. i Project Name: i dr DETAILED ©E-.SCRi 710N OI=WORK: I h+auAnse r CO' STRUCTION INEORMA t N: 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: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: i OWNER/LESSEE: CONTRACTOR: Name Name: Addriftct i Company: City: State: Address: �N Zip Code: geo k Fax: I ' City: State: Phone No. 'S2�' i Zip Code: Fax: E-Mail: Cevx Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License LLIfvalue lue of construction is$2500 or more,a RECORDED Notice of Commencement is required. i of HVAC is$7,500 or'more,a RECORDED Notice of Commencement is required. I ' I i ROM LEMENAL CONST' NV LI W I -O TION: 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 thepermit 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 RNEY BEFORERECORDING YOUR NOTICE OF COMMENCEMENT." Signatur of Owner/Lesse /Contractor as'Agent for Owner Signature of Contractor/License Holder S=ATE OF FLORIDA STATE OF FLORIDA COUNTY OF / COUNTY OF The forgoing instrument was acknowledg��efore me The forgoing instrument was acknowledged before me this-� �lay of 1 ,[ 2atiby 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 Produced (Signature of Not Op (Signature of Notary Public-State of Florida) �� .� ,VP�,, ELLEN VAUGHN Commission No. a°` sState of Flo(84a otary Public Commission No. (Seal) _* *= Commission #�G 270079 =� P My Commission Expires FF.O�� ' REVIEWS FRONT +ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.