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HomeMy WebLinkAboutBuilding Permit Application All APPLICA L��E""INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Vllab Permit Number: lJ� Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: @© MP10"Mo O ON 22 Address: 510,�`L01J J1�i l l u S . Property Tax ID#: 1_�) ON CD� ( CO�- ®(� � Lot No. Site Plan Name: Block No. Project Name: DET D 13E�SCrR ION ►F OR bOve. nd 0 L&-)Ehm CCaNS RUCTION fN -ORMATION: 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 Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ L Utilities: _Sewer _Septic Building Height: COMM NER U&SSEE: CONTRACTOR: Name W,Wk C, " '� ' Name: Address: S Ck v( A,'-L Company: City: 91a a State: -ft- Address: Zip Code: �) S Fax: City: State: Phone No. -1'1 r}L ` �l y Zip Code: Fax: E-Mail: S I ,_CofyJ Phone No 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. 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 Hqme Owners Association rules,bylaws or ani cl9venants 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 i 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 -_i17lICE_FORK IMPROYEMENTSTO YO_R"PROPERTY _A_NOTICE'OF CO .MENCEMENT MUST BE RECORDED AND' :> (Project Street Address or Property Tax #) - i STATE OF FLORIDA STATE.OFCA FLORIDA -"-- COUNTY OF �S� -CQ��Q COUNTY OF r r L� The forgoing instrument was acknowledged before me The forgoing instrument was acknowle.g d before me this day of d-/ ,20LO by this today of Name of person making statement. Name of person makings em i Personally Known OR Produced Identification Personally Known R Produced Identification 1 Type of Identification -Type of Identificatio Produced ( D Produced �`. �PJa•., ELLEN VAUC (Signature o ,, 8 u _ic- fiF(�d�i r °e ° �ii4) �ia'dfiU€ D� a) Stat0 of Florida -Notay Public ss on 270078 .,��oFn�"°� My Commission Expires Commission *& Comm 'i 4t 0 70079 '"' `` No, October 2 (Seal) pirbs s. C ryii�llnSl e� . b�teb®r 2.2 zoz� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.