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HomeMy WebLinkAboutBuilding Permit Application (2) All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date: Permit Number• u rV'M .......... itx s, R v , ...:::sz1 G,c`.`-•v'v AY _. Building Permit App icatiody 2020 Planning and Development Services Permitting D e a rt1 t Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucia CL Y t��r FL Phone: 772 462-1553 Fax: 772 462-1578 Commercial ( ) ( ) Re3rd-entlal � PERMITTYPE: PRO SED IM ROUEMHNT MONK&A Address: Property Tax ID#: v - (��' Lot No. Site Plan Name: Block No. Project Name: DETA 11119D ' O1 OVA R+ CONSTR�UCTIQN I1N0ORMATI©N: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping 0_<15'hutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Constructi Sq. Ft. of First Floor: Cost of Construction: Utilities: _Sewer _Septic Building Height: KV&F,N[B RA 0 0 1 CONTRACTOR: Name `n Name: sn l Address: ® � S eON �` Company: `W-A 'c -es City: State: Address Zip Code: Fax City: S�, State: Phone No `1 Zip;Code Fax: E-Mail: "Ltz" hone No O G Fill in fee simple Title Holder on next page(if different E-Mail 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. SUPPLEMENT L CONSTRUCTION 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 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 W H YOUR.LENDER OR AN ATTORNEY BEFORE RECORDING YOU TICE OF COMMENCEMENT." Sig ure of Owner/Lessee o tr or as Agent for Owner Signatur Contrac or/License H TATE OF FLORID ) ST OF.FLORIDA r COUNTY OF � L/il! / e- C UNTY OF J�- CC-'I t— The forgoing instrument was acknowledge before me The for oing instrument wasacknowledged before me this day of 20�by this day of -0 21k . ��-i Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of.ldentificaNn Type of Identif' tion Produced J. �'�i ' �- ProducedJ_ ��` (Signature of Not Public-State of Florida) (Signature of Nota• Public-State of Florida) N Commission No. "'YP; •, AUDR �. PHREY Commission tYP ''••, AUDREYB.HUi'II�R MY COMMISSION#GG 300817EXPIR—ES:Ma v-6,2. , MY COMMISSION#GG 300817 e= 'Mr F; nded Thru Notary Pu lio Unde 't `. a Bon ed Thru Notary Public U REVIEWS R PLANS V ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED iev. 2/7/19