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HomeMy WebLinkAboutBuilding Permit Application (2)All APPLICABLE INFO MUST BE t PLETED FOR APPLICATION TO BE ACCEP .'_c Date: �'�'70 Permit Number: 0 $ 20BuildingPermit ApplicationLR:EECEIVED: unty, Peng 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: fIP.R[1Pff.+,FO`rIMtPRflVEMENT LC)CATIflN. �.^�. d. � '•- Address: n"� r3A 'r\ C' L�C0 5 �yU PropertyTaxlD#: ON' QQLS' ©��P�O r%��'r1 Lot No. Site Plan Name: Block No. Project Name: Gala 7lIC r)114"NInf Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction:2 ga Sq. Ft. of First Floor: _ Cost of Construction: $ D,4 :00 ' 00 Utilities: _Sewer —Septic City: 2 \� �4��4 `��)-.l.....I Zip Code: D— Fax: City: Phone No.Zip Code: E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County If value of construction is $2500 or more, a RECORDED Notice of Commencement i5 rec If value of HVAC is 0,500 or more, a RECORDED Notice of Commencement is required, -Windows/Doors Roof Pitch Building Height: Fax: State:_ DESIGNER ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: _ Name: Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: Address: City: _ Not Applicable BONDING COMPANY: _Not Name: Applicable Address: 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 subject structure which Is to 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' r //lL Signature of Owner/ Lessee/Contractor as Agearfor Owner Signature of Contractor/License Holder STATE OF FLORIDA �qq STATE OF FLORIDA COUNTY OF .'�t� LUCi � COUNTY OF The f Ding instr en was acknowledged before me The forgoing instrument was acknowledged before me thisdayof U ,20WI:iy this_dayof O nT m Rk I-(C \1 P/K Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Type of Identification (Signature OT NOTaryrTl 011t- JLdW ul rwi wa 1 Florida- 1 S. p o a y Public Florida-TT�aa Public Commission N :o � ; b_= Commission N GG 207484 My commission - ,�' June 12, 2023 REVIEWS VIS COUNTER REVIEW REVIEW DATE COMPLETED Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- state of Florida ) Commission No. (Seal) PLANS VEGETATION SEA TURTLE=VE REVIEW REVIEW REVIEW