Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ���9 1 Building Permit App katiorVR 2 0 202.0 Planning and Development Services Permitting Department Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lude 0ll`lty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial Reside'ntiaf— _ I PERMIT TYPE: PROPOREDDII PR01/EMEN LOCAT)©N, Address: �:28 Property Tax ID#: A°fl1Lot No. � Site Plan Name: ���� inrr�� Block No. Project Name: rl( ED DE�SCR+lPT10N OF WOR+K: .i_AA1 me , CONSTRUCTION INFORM 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:$ Utilities: _Sewer _Septic Building Height:' OWNER/LE--SSEE: CONTRACTQR: 11 Name „r r Name: AddresA+ Rim Comow s: �� G Company:, City., ,;I✓I State: Address "�7 v `' ' ' Zip Ce: - t� Fax: ,City: ”i ...; �, ,'S od - tate: Phone;No "1.,, 'LLda,��, Zip Code 3� J'3 '' ' Fax. I Phone No Fill in fee simple Title Hold on next page(if different E-Mail � Il 6 — wa 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. �UPPLEM'ENT MINOR NSTRUCTION t,IEN LAW 1NFC�RMATl4N` 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 0WNER: 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." lyl)J_ Ln,�� Signature of Owner essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF /, !� COUNTY OF Sems' �— The forgoing instru ent wa§acknowledged before me The forgoing instru nt was a knowledge ,before me thisa�Dday of 20� by this day of 20 1-7 Name of person making statement. Name of person making statement. l Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of N - (Signature of N ry Public-State of Florida) AUDREY B.HUMPHREY Commission No. ' ' '= AUDREYB.H IEY MMISSIt�SIG300817 Commission No =;v`.•'"r� ••, Pte: EXPIRES:March 6,2023 A ;► COMMISSION#GG 817 9rwrilers s,r P? EXPIRES:Match 6,202$ °F r4ed Thru Notary Public U ideWters REVIEWS FRONT ZONING SUPERVISOR PLANS VE ISEA I UK I LL MAN OVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. f .r P