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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_ 3` �1 , Q.113 Permit Number: ado3'Oa� ire „$;tel°w COUNTY RECEIVED Building Permit Appli atiOAAR 112020 Planning and Development Services Building and Code Regulation Division ST. Lucie County, permitting 2300 Virginia Avenue,Fort Pierce FL 34982 \J�/ Phone: (772)462-1553 Fax: (772)462-1578 Commercial / \ Residential PERMITTYPE: f�PC`j /til 61Z Z —Lh G RC1'O- �D PRU1/EMT LOCAT O Address: 9 5 Property Tax ID#: ti �b �` �� "" bJ Lot No. ®` Site Plan Name: Block No. Project Name: SET FLED DEQ=0R,IPTIQN WFAWSR,IK: CCh, n /-- P CON TRUCTIONINE,M TON• Additional work to be performed under this permit-check all that apply: _Mechanical —Gas Tank —Gas Piping _Shutters —Windows/Doors —Electric Plumbing -Sprinklers —Generator Roof Pitch* Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ ( Ca Utilities: —Sewer —Septic Building Height: OW100%LESSEE: C©NTRACTOR: Name ¢ UZICz Name: ' r Address: I d Lie L t Company• T N"'r G City: �P.tQ elg' St l l4(-_7 v - State:_L:�� Address: 6 V s V Zip Code: Fax: City: "�� ! State: �- �/�� Phone No. Zip Code: 3 1 qJ1 Fax: E-Mail: Phone No 7?o� 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. SUPPLEMEN AL C�NSTRUCTI�N II3N LAW Ff�7RMATI�N• 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 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 YOJM LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Ale,, Signature of Owner/Lessee/Cordactor as Agenoor Owner Signature of Contractor/ icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF !!C-� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of Vv.-x1— 120 at by this N1 day of 2( � by Name of person making statement. Name of person making statemen . Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced e;L 1D L' Produced (Signature of NotaryPublic-Stat - "' (Signature of tori GI`dvI1S DF�1Nllr° I�AR E GG G22023 �,oPnr?s , DEANNA MARK Commission No. OA"�iY i; YCOMrd1�q�'i eiag 2ov �� Commission MtdISS14Nt?(Sbal) i= e EYPtRESuece ub11cU dertmter EXPIRES:Decembui ndedN Hp ery p - ';FodF�Q Bonded 7hru Notary Pubic U,i REVIEWS ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19