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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BEII'COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: —m/ - cx)25 Building Permit Application Planning,and Development Services °%A- `© Building and Code Regulation Dl vision 2300 Virginia Avenue,Fort Pierce FL-34982 °� .Phone: (77Z)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT TYPE: Address ` n r �- 11q Property Tax ID#: o oxa— 6o of Lot No. Site Plan Name:' Block No. Project Name: (�ZIA 1 AMM �c 6 iNk Glc miz yovse Additional work to be performed under this Permit.-check.all that apply: _MechanicalGas 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: Utilities: _Sewer —Septic Building Height: Name Y,i, Name: Address: 1 (, Company,: city:. qlf-� State: Address: Zip Code: Fax: City: State; Phone No. 51 to ' 7b$ -S 1)$ Zip Code: Fax: E-Mail: Y'C(�(Ner 2-LJ c+QDG, V coo 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. � � cz:c4 DESIGNER/ENGINEER: — Not Applicable MORTGAGE'COMPANY: Not Applicable Name: Name: Address: Address:, City: State: City: Stater 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 AFFIDAVIT: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.Lucle,County makes no representation that is granting a permit will authorize the permit holder to build the subject structure Which is in contlict 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 POSTEWON 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." ru", r7 l � Signature of Ow r/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA 'STATE OFFLORIDA COUNTY OF ��C(� COUNTY OF The forgoing instrument as acknowledged before me The forgoing instrument was acknowledged before me this day of 20-,LDy this day of 20_ by X61 Q. Name of person making state Name of person.making statement. Personally Known OR Produced Identification. Personally Known OR Produced Identification Type of Identification nn Type of Identification Produced F(_ !J� Produced Vv (Signature of Notary Public- )e of Florida-Notary Ali ature of Notary Public-State of Florida} Commission #GG 270D79 -� P` Commission Ex Commission No. "��n�i�°"� �S��Oetober 22, 2022 ego fission No. (Seal.) REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED V.