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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: r: %) • 20 Permit Neu L Building Permit Ap Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, FortPierce FL 34982 - Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial FEB 11 2020 r' cation Permitting Department St. Lucie County, FL Residential_ PERMITTYPE: ( ) '& P(-' .46 J r i • • _Tr7rirli!`*+`�"`�'/1/ILA Property Tax ID #: Site Plan Name: . Project Name: Lot No. Block No. 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 Total Sq. Ft of Construction: �I� Zk Sq. Ft. of First Floor: Cost of Construction: $ 0 ;lY ©V • r% Utilities: _ Sewer _ Septic Building Height: Pitch QWNER TIESSEE: Couli ' - OR: Name dV AAQ vNLL l Name: V%��)�q Address: (PS Tor. Company: L-% rvll4c%i 0 cf2Q g City: (iF ZipCodeX Fax. Phone N.. , C) O Z_ Addresrs,^'S D l G0ci (K =il'i City: te:� Zip Code: Phone No 7 •%2—J i ?—Z':57- """"" E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail State or County License 7 O O !2 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. PPE TA N RUCTIO N ,W O . MORTGAGE COMPANY: _ Not Applicable Name: DESIGNER ENGINEER: Not Applicable Name;%�1�41 C LT In f c I rZ� AddresW Y � ntJ Address: City:,fi&ILE Zip: ,!�49 S/�Phone 722= State? %A City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Not Applicable BONDING COMPANY: _Not Applicable 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 subjects tructure 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 YQ"NTEND TO OBTAIN FINANCING, CONSULT WfEHi YODR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMME.NC)6MF•MT." Sre of Owfor as Agent for Owner ign eontra ct/L Signatu of Contraor older STATE OF FLORID STATE OF FLO COUNTY OF COUNTY OF The forggoing instrumen was acknowledged before me The forgoing instru nt was acknowledged before me this 1 1 day of , 20_�2fby this _)i day of �. 20_ by Name of person making st/atement. Name of person making statement. Personally Known v OR Produced Identification Personally Known FOR Produced Identification Type of Identification Type of Identification �`• Produced Produced (Signature of No Pu lio- State of Florida (Signature of Public- State of Florida ) Commission AVDRE2112— �IEY Commission �. ¢s �DREYB.HUUP ISSIDN 1T .• . SSIONA 1T , 4. EKPIRES:Mard16,2029 EXPIRES.Mamh6,2023 VEGETATION S REVIEWS I SUPERVISOR PLANS GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.