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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: • ' 1P 414 02 Building Permit Applicatioris�,�ry �29 FQ Planning and Development ServicesO Building and Code Regulation Division 4` 0/0 10 �O 2300 Virginia Avenue, Fort Pierce FL 34992 Co Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential rp ERMITTYPE: New Cc�A)S?Ctucr.�'�02J Address:_ 51 4YI A)W Da V. -i i24( ljl;y-7- �-ex E PropertyTaxlD#:�3 5Q�—�� !'' ..,���---• Site Plan Name: Project Name: XI,4t,,W dri0-1 F+'Al Cc Lot No. Block No. AdditioI work to be performed under this permit—check all that apply: _Mechanical _ Gas Tank ` Gas Piping „Shutters _ Windows/Doors ,/Electric L.--,PIumbing _--Sprinklers ,Generator LZRoof �''� Pitch Total Sq. Ft of Construction: _ S ej 7-�` Sq. Ft. of First Floor: It �r Y Cost of Construction: $ 6 ('O o0 O X.� Utilities: ✓Sewer :.. Septic Building Height: OWNEPQ1ESSEE: GONTRACI Name Cl Name: Address: 51 !�1 NW 't,4) 0 L Company: City: pa plIP-C 4E_State: Address: Zip Code: Fax Phone No. I E -Mail: Sv), ^%(3YV v,,-140 ovYYv- d04.nz , Fill in fee simple Title Holder on next page ( if different from the Owner listed above) , ' -• pity: State: Zip Code:. Fax: Phone No E -Mail 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. SUPP' ME A CONS TRU I© EN LAWI WM A ION: DESIGNER/ENGINEER:' Not Applicable MORTGAGE COMPANY: Not Applicable Name: J Sau- tA-G Name: Address: #106 u3 Address: City: u• Q State: City: State: Zip: 34!R 2 Phone q!2Z BASG'3641 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 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." 50 010VA4 Mo C1 Signa re of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF_S4-­AO COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this I`:% day of Mu,('GY\ 202_D by this day of 20_ by SAc t)( Qca .o ►1 , C7 Name of son making statement. Name of person making statement. Personally Known OR Produced Identifica Personally Known OR Produced Identification Type of Identification �\,��L�EQR G��/j Type of Identification Produ ed Dr�,wc nS� oo y1P,..•••.••F� Produced q :�vO��gER 1) �p•. i_ (Signature of Notary blic-S of FI�i2a.)o #tGG926545 `y Sgnature of Notary Public-State of Florida) Commission No. C1L-I G2Gi5�IS �)��yAbjdcUnde:��'•oQ ��`ommission No. (Seal) STASE�R �R "fill III REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19