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HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �7�i�%�v Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: JaA_ PROPOSED IMPROVI=111lLNT..LflCA Address: ©c: i��>✓ C�k/vim fjl �v� Property Tax ID #: Site Plan Name: Project Name: Lot No. Block No. ,tSTRUCTION INFORMATION._77 Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric GX Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: O1't NtR,lCt' EE .. , Name Address: City: State: _ Zip Code: Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: Address: City: 7 v' 6`y7State: f Zip Code: Fax: Phone No / g E-Mail aJ 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. DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone:_ MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: 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 as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA r'�' f >' STATE OF FLORIDA ,�. r �` �' "``7, COUNTY OF °f-f COUNTY OF The fo!Foing instrument was acknowledged before me The forgoing instrument was acknowledged before me this --day of f �'� <�1 , 20'-- by this day of j ,•v - - C 20G %by XX­ Name of person making statement. ` Name of person making stateiTfent. Personally Known FOR Produced Identification Personally Known C�-OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- Stat nature of Notary Public- S o61•-., NICHOLAS MrrT00 Commission No. � • al tary Public - State of Flo Commission # GG 92246 'to ��pr"vie;,, NICHOLAS MITTOO mission No. 1 ��` aa� j�{uublic State of Florida � ` Coinrfiission # GG 922464 'for My Comm. Expires Oct 22, 023 ? of F My Comm. Expires Oct 22, 2023 REVIEWS FRONT PLANS VEGETATION SEATURTLE MANGROVE ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE _ COMPLETED Rev. 2/7/19