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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �' 4' Permit Number: �� IE COUNTY Building Permit Applicatiofp� Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982Q, Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _� PERMIT TYPE: z5-/-e cr��, �TG� Cly RENOMWOMEff LOCA ION: Address: --R 2J 3 � C�'"al1-Y �)o� C�v`,-L `-1 r.- Property Tax ID#: [(Q-03-(' + ��� Lot No. Site Plan Name: Block No. Project Name: C(sele,7-A Gg( At ,-Pi•- ©ETAItED DEx5CRiPTION OF ORK: 7Z 7� r, c,9 CONSTR,UCTIaN 11,NFO ATIO I 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:$ 2 you Utilities: _Sewer _Septic Building Height: OWNER/�@56.1 CONTRACTOR: Name ` C Name: o Address: 39-13 CQAd L,-and G 77 Company:' .c -Ke /G.'c City: ps C- State:j�-7 Address: r v� Zip Code: 3�( ?. ! Fax: City: S �- State: Phone No. Cl �'+ Zip Code: ��� �J Fax: E-Mail: Phone No i Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 30 S g9 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 UFPLEME TAL CONSTRUCTI©N L EN INFO ' A QN: 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 AURRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Ow er/Lessee/Co.ntractor as Agent for Owner Signature of Contractor/Lic s older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-k-Lkkoc COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledges before me this�day of 4N'V�N� 20 X-4y this LJ—day of f`{Ya� 20 'W by D),, &2?,=, Name of person making st tement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification 1 Produced -L D Produced �QL (Signat (Signatu ELLEN AU "" L EN VAUGH E B ;1pRY PL',i%;State of Florida-Notary�P�u��lic 0 ��_State of Florida-Notary/ k r Commis # GG 2 Wb Commiss' a• ' # GG 2�oP My Commission Expires i9�o oePc' My Commission Expires��` October 22, 2022 �''������``� OCtOfflcw�WORM"Mams- PMRIN �. \ W*Wxbo-�— REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.