Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ! RECEIVED 0 0 Building Permit Application APR 2,8 1010 Planning and Development Services Building and Code Regulation Division Pcrnus5ing pt'g9rtment 2300 Virginia Avenue,Fort Pierce FL 34982 St.Lucie -gunk Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PROPOSED IMPROVEMENT LOCATION: j Address: © � C/^ Cir,/ E Property Tax ID#: /4(4s-- 2/01 C�/,'j�' -� 00o",,Z S� � Lot No. 3 _ Site Plan Name: E40//APs IAA Block No. b Project Name: _612EW7 DETAILED DESCRIPTION OF WORK: 41 CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: J_Mechanical _Gas Tank _Gas Piping _Shutters I/ Windows/Doors V Electric L/ Plumbing _Sprinklers _GeneratorAL Roof Pitch Total Sq. Ft of Construction: [� ` Sq. Ft.of First Floor:...9T! /5' oc� ' �L I > Cost of Construction:$�J�AV�Q. DG Utilities: —Sewer J Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name cto OF K. Name: 4 r W Address: 04 a 9' iJV CiA Company: RY filvf_ � � � G• City:vzko State: IGS Address: 1)?617 ( Zip Code: Fax: City:EXar��� Stater Phone No. 2; �1— 7��"V` / Zip Code:.3y9tc Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail 71&G&ML,_6Ow 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. I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: b Name: C Q Address: ! Oy Address: City: ,� State: City: State: Zip: Phone,.State: Zip:. b Phone: 06 - - D FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ,KNot 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 stricture. 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." i i Si nat o Owner/Lessee/Contractor as Agent for Owner Signat r of Contractor/License Holder STATE OF FLO IDA STATE OF FLORID COUNTY OF . LuCi f COUNTY OF S+� . Z UC t e. The f rgoing instrument l as acknowledg d before me The f oing instrum nt w s acknowledgOby efore me this&L day of (�(1C� 20E by this�day of C^� 20 Name of person making statement. Name of person making tement. Personally Known /-OR Produced Identification Personally Known making Produced Identification Type of Identification Type of Identification Produced Produced 6�D IQAb;V�, WO 6—A ,J (Si nature of otaryPublic-State of Florida (Si ature of Nota Public-State of Florida) Commission No. ""rP LY LOUISE(FW h'QN•BYRD � ' KEELY LOUISE H QN-BYRD o Commission No. :o, �: �__`_{ Notar Public State of Florida Notary Public• tate o Florida a. Lg. Y n N GG285394 .. oI Commission p GG 285394 '°F�`''` M Comm.Expires De 18,2022 ^ ^ y omm.ExpiresDec is,2022 REVIEWS ISOR PLANS VEGE ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW; DATE RECEIVED DATE COMPLETED Rev.-27770