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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED z R Date: _ � Permit Number: ©4 J u DECEIVED Building Permit Applicatio MAR 1 1. 2020 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300.Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial- Residential _ X PERMITTYPE: PROP-5 BD IMPOVBMBNT 09f,MAI IO h Address: e(l _41", 442 Property Tax ID#: J f�f% ®� 7,2(� oC��- Lot No. Site Plan Name: Block No. Project Name: DE ILBD DESCRIPTION OF WORK: t�- J fONSTR,UCTIO .INFORMAT ON: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters'_' _Windows/Doors = Electric _Plumbing _Sprinklers Generator koof '-. - : ': Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ (1/ Utilities: _Sewer _Septic Building Height: O NER/LESSEE. CONTRACTUR'Y NO Name Namet - Address: Company: City: State, Address: Zip Code: Fax: City: ,r,,., ,•, '_State: Phone No.�_72_ 0—&4L Zip Code::1 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. ' SU'PPLEM'ENTAL CONSTRUCTION LIEN LAW INMUDRMATIiWN; DESIGNER/ENGINEER: ' ,. , Not ApplicableMORTGAGE COMPANY: Not Applicable Name: Name: Address: �y�► r., �Y"°vg A�ddrg City: Catty;, . # 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 the permit 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 Agent for Owner Signature of Contractor/Licehse Holder STATE OF FLORIDA ' STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument w acknowledged before me The forgoing instrument was acknowledged before me this 1 day of 20M by this day of 20_ by P�; Name of pers n making statem4nt. Name of person making statement. Personally Known OR Produced Identificationy/ Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature - (Signature of Notary Public-State of Florida) �Sy pVe/,� KAREN S. NIELSEN Commissio At , State of Florida-No(SulF ublic Commission No. (Seal) =* Commission # GG 207484 oa My Commission Expires rmimne 12, 1022 REVIEWS rRMMT =10 UPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE- COUNTER REVIEW REVIEW REVIEW REVIEW . REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.