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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED [� 1 Date: Permit Number: ()(97 Building Permit Application APR 2 12020 Planning and Development Services Building and Code Regulation Division Pei i i itpria e o:1a rtm .nt 2300 Virginia Avenue, Fort Pierce FL 34982 E Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentia�t , ; 1,- y D PERMIT TYPE: P OPOSED IMPRO\/EMENT LOCATION: jj Address: Coo— Property Tax ID#: .J`'f �o� ' �O\ `'fid' Lot o% r l ` Site Plan Name: Block No. , LI Project Name: D TAILEDDE�SC*RI'PTI, N OF WORK: Pee5-V - F1 I ? 002 , I oral - rl 1y31rzI [W NON[RUCTION T1NFOR,MATINN' : Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shuttersendows/Doors Electric _Plumbing _Sprinklers _Generator V Roof Pitch Total Sq..Ft of Construction: p� Sq. Ft. of First Floor: 90D Cost of Construction:$ "i©y • Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: :# CONTRA Name 05k lM !' cti.-p- Name: Address: 1 T 5 cA SJ-r---r Company: City: C.1�.5 c C �- i "P State:_ Address: 35'2-� PFrA --e_\L j vJ ew Zip Code: Fax: City: N& C- Stater Phone No. Zip Code: Jv�`t�y Fax: 33L -�-SG r E-Mail: Phone No 50 I0 ^3 ea-0 Fill in fee simple Title Holder on next page(if different E-Mail ��u Q o �'yn-T-eC�C�-$T7o r1 from the Owner listed above) State or County License ecc 3 Z 2 b 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. SUPPLEMENTAL CONSTRUCTIQN LIEN LAW INFORMATION. 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 OWNER: YOUR FAILURE TO RECORD,A NOTICE OF COMMENCEM T MAY RESULT IN YOUR PAYING TWICE. FOR- IMPRO EMENTS TO,YOUR. PROPERTY.`A NOTICE OF If hMJS1_BE RECORDED AND POSTED O E JOB ITE BEFORE THE FIRST INSPECTION. NTEND.TO OBTAIN FIN ING, CON ULT WITH UR LENDER OR AN ATTORNEY BEFORE RECORDI UR WnICE OF COMMENCEMENT." Si ature of essee/ s Agent for Owner Signature Contractor/License Hold r STATE O FL RIDA STATE OF FLORIDA COUNTY (`(1 A c1->,n COUNTY OF h1 1)C4n The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this lv)iay of A p L ,20aO by this (c'"=day of 1�piul 20ZD by a tom:r} j t 1 �j� 3 ala dam`"NnT � � �V V •� a F,�o�o Name of person makings tement. 0� `qnL � r� Name of person makin7OR ment. 60 .G��Q Personally Known OR Produced IdentifiE ti , ? `+� Personally Known Produced Identifica r r� • �z Type of Identification F E. Type of Identification ' �= NProduced `o a �� ro .y Produced o `� Qk ty N'J 3 c,7i5 (Sign ture of Notary Public-State of Florida) W.a.o y, (Signature of Notary`Public-State of Florida Com' 5 ) Commission No. f_e 1 �s�93 (Seal) .3 Commission No. 1,5 I �3 (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. I