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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BEC MPLETED FOR APPLIC#TION TO BE ACCEPTED v QV�-�. - Date: �� �'�� � Permit Number ((«]] 3 ,•� A rhe td t .�e 2020 Building Permit Applic tion Planning and Development Services Pei m itti.rtq Building and Code Regulation Division �, y Ment .c St. Lucie Q ung FL 2300 Virginia Avenue,Fort Pierce FL 349821 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOS 6/ED IMPR©VEMEN LO rATtK n Address: �0 D("Gj Q f•f l' C 2SiteProperty Tax ID#: 1�3 19 — Lot No.� -2- Site Plan Name: Block No. y Project Name: L(J -D!/L 'r<c)/'V P J� DETAi'L D DESCit)PTIUN©F=MR K: Ifo, L R ooh oy (fc Sh i/icrl e x"64 C©NSTRUCTOWN N INFa,RMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator VRoof3 �, 0�1 Pitch Total Sq. Ft of Construction: , / ON , Sq. Ft. of First Floor: Cost of Construction:$ 5000.00 Utilities: —Sewer —Septic Building Height: O�WiNER/LESSEE: CONTRACT©R: Name #NTa i NILTE- .1A1flt UJ I E Name: 5A Im L Address: !�� D D Fora VU Del Company: City: State:� Addres`s: Zip Code: 339 i Fax: City: State: a�. Phone No. 77o� . _3 ��9 /y Zip-Code: Fax:, E-Mail: QE'G L4of r),e- C Vrq 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. SUPP AMENTAL C N TRU Nil© LI IN W,I f MT11ON: 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID - STATE OF FLORIDA COUNTY OF / .r. COUNTY OF The forgoing instrum t was acknowledged before me The forgoing instrument was acknowledged before me thi.s--W day of 4L 2Q-_V by 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 Identi ' ion Type of Identification Produced Produced (Signature of Notary ublic-State of Florid (Signature of Notary Public-State of Florida) Commission No. REV PREVIEW Commission No. (Seal) •*::;REVIEWS FRPLANS VEGETATION SEA TURTLE MANGROVE CO LATERREVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.