Loading...
HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � Permit Number: a' , ryi Fp Building Permit AppliCa neo Planning and Development Services .c°d,� Building and Code Regulation Division `t�,�N 2300 Virginia Avenue,Fort Pierce FL 34982 E Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT TYPE:O �. r R �9.CD tNIP 0 E N LOCAT{ Address: f � L II Property Tax ID#: Lot NO.' Site Plan Name: Block No. Project Name: ),/ ILEI3 DRUZA R,1 PM IO tl3 OR �. 10I 6qae__.1 it I CON?yTI� CTIA INF©RTION.: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers Generator VRoof Pitch Total Sq. Ft of Construction:—L"7 Sq. Ft. of First Floor: Cost of Construction:$ ny0o Utilities: _Sewer _Septic Building Height: attilN� /LI -SSPE.: CONTRAC Q'R Name Name: Address: Company: City: - Stater Address: Zip Code: G' ��� Fax: City: State: Phone No. Zip Code: Fax: 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. i I MIA MEMNON r DESIGNER/ENGINEER:. F 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 an 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^THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR ENDER O N ATTO EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.- U. /Sjl nature of Owner/Lessee/Contract as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA . i STATE OF FLORIDA COUNTY OF COUNTY OF The fgrgoing instrument wasacknowledge —before me- The forgoing instrument was acknowledged before me this day of 20 y this day of 20_ by Phil i�Gra � � - Name of person making staterdent. v Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificati Type of Identification Produced Produced ua I (Signature of Notary Pu c-State of Florida) (Signature of Notary Public-State of Florida) Commission No. S e a I I ELLEN VAUG 'ssion No. (Seal) �aState of Florida Notar =a *� commissio Public Pnii+`�1` Ommission E pir REVIEWS FRONT 2 . SVEGETATION SEA TURTLE MANGROVE COUNTER REVIEW ' REVI 4. REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19