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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUSST� BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q0� r✓6 Date: Permit Number: 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 PERM IT TYPE: ��'�G�i'ti;✓1 PROVEMENT LOCATION: Address: 55 744--1E/eir leI 2 - �0/ - D7� y -- 0(90 " ! Lot No. 5 Property Tax ID #:��//���% Site Plan Name: Ale_#Iet Block No. Project Name: 55 DETAILED DESCRIPTION OF /WORK: a s9.. -,l O✓�t t{ �% '; off �,, Ve 7a /'P�, CONSTRUCTION INFORMATION: 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: 5Sq. Ft. of First Floor: vv Cost of Construction: $ ryv��.•�o Utilities: %Sewer _ Septic Building Height: Name 0 1 !J -A E. el- Name: Address: ."ZQ lye,—?/V,"/ SII Company: City' 36e7fei? &ac, f State: Fl . Address: tsG/ ✓'✓� �/h'.�c �� S�i Zip Code:.3`/5F67 Fax: City: T1n.11t?n 49egc A State: /CL. Phone No. %�l ��©� y �0� Zip Code: 3v75,7 Fax: 772--232-x)21 E -Mail: Phone No"" Fill in fee simple Title Holder on next page ( if different E -Mail ctt�cdM S✓�i �'`j %r1C�yp/�oC • L Ch1 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 $7500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINE _ Not Applicable MORTGAGE COMPANY: _ Not A4)1s1icable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable ING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: ne: Zip: Phone: OW 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 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 YOURIENPER OR AN EY BEFORE RECORDING YOUR NOTICE .,COMMENCEMENT—"-"` z� I �"00 Rev. Sign e of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Ho er STATE OF FLORIDA STATE OF FLORID �Q COUNTY OF )�' 1'�I COUNTY OF ;l r-� � y� The forgoing instrument was acknowledged before me this �t`-day of �r� , 2Q�� by The foToing instrument was acknowledged before me this �hday r�� , 20� by A�i a ru � �-n ��}-1A Ada rn Name of person making statement. Name of person making statement. Personally Known OR Produced Identification_ Personally Known OR Produced Identification � Type of Identification '�pyl[,10..I�1'IVQ,1-�•ICsr-YtSs�.� �I-.- Type of Identificati n yy�� Produced�C�l"�C��< U�-- e-D�- Produced (Signature Notary Public- State of Flor��l�) (Signature Notary Public- State of