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HomeMy WebLinkAboutpermit app SheppardAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: COUNTY F L 0 R, r Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1S53 Fax: (772) 462-1578 Building Permit Application Commercial Residential PERMIT TYPE: ; C...� 1 b 0 c r PROPOSED IMPROVEMENT LOCATION: b 0 � Address: L Z o 5 Property Tax ID#: C3©O Site Plan Name: Project Name: `V---r DETAILED DESCRIPTION OF WORK: A0 o- Zc-- 4z� { CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Lot No. 3 Block No. 1` _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: $ 6336, 0 o Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: �s Name�#r--5 Name: ( �r4--,r s �C-1, Address:S� i�a� Company: C-D � C City: _E_ c�/.� _State: Address: Z 2> 1. Dew-v ^, ! Zip Code: ,31(9 iK 3 _ Fax: City: � State: �L Phone No. i 7 3 Zip Code: ! �J � Fax: E-Mail: Phone No 7I L' - Z To. - Fill in fee simple Title Holder on next page ( if different E-Mail Ps S, l M �) from the Owner listed above) State or County License L 6 �' 6 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable _� Name: MORTGAGE COMPANY: Not Applicable Address; Name: City: Address: State: City: State: Zip: _ Phone Zip: - Phone: FEE SIMPLE TITLE HOLDER:__7 of Applicable Name: Address: City: Zip: Phone: BONDING COMPANY- Name - Address: City: Zip: Phone: Applicable 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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in contlict 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 NO TfCI: OF COMMENCEMENT." of Owner/ Lessee/Contractor as Agent for Owner -Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORID COUNTY OF pt&r-; /1 COUNTY OF �_LI-1 The fing instrument was acknowledged before me thisday of d226_2pby Name of person making statement. Personally Known " OR Produced Identification Type of Identification Produced S ature of Not _ , c a# dA`FMA446I0ry #GG 274212 EXPIRES: Novemh0r 25, 2022 Commission No. °.".:�' Bonded IYpu��ctinder�clr::y REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED The forgoing instrument was acknowledged before me this JL day of > 20 n by C—� s- 14 S if) c--" .•) Name of person making statement. Personally Known OR Produced identification Type of Identification Produced 4' aM ature of Notary Pu ` " �*, • { Of :Ffor Ic�,�`,�I �iwFd # GG e74212 " 9 Commission No. %fin s Ball %I er2r. U22 SUPERVISOR I PIANS IVEGETATION I51ATURTLE RUI MANGROVE REVIEW REVIEW REVIEW I