Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED LJUN Date: �I Permit Number:WIN .VDT' 2 6 ' 019PermittingBuilding Permit ApplitatiCounty, 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 PERMITTYPE: ENO § E 6IMO EMENT LOCATION: Address: l Qi J 9, 5 US 14Wy ParF Sf. Lw4 Property Tax ID#: 3yjy.SoI _gool-aSO-? Lot No. Site Plan Name: Sc�rhP°r� P)✓i7-4 Block No. Project Name: 6• 61-e 13 e b e✓pr} �,` LTis f- C4 w, l Additional work to be performed under this permit- check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Electric KP.lumbing _Sprinklers Generator Total Sq. Ft of Construction: �� Cost of Construction: $ Name 3 te e Id i1 9 ' �C- Address: 8G N,dIQ �" er (� r Sq. Ft. of First Floor: Windows/Doors Roof Pitch Utilities: _Sewer _Septic Building Height: City: P $`%I Zip Code: �c $ 4 Fax: Phone No. rely . E-Mail: Fill in fee simple.Title Holder on next page ( if different from the Owner listed above) Name: (/_n<,; Mu/ c/Y°h /htllv�J(U'"i Company: t? r (.na (o cirrch'ah Address: City: VRrO'RPgc� State:,F� Zip Code: ,3a9.(o Faz: ' �]3'-RiJ7T65 Phone No `77P7b374_0.I-DI E-Mailcf rr r. 0 f�Z'L o. tG+n State or County License C-6 GI SI (D I L 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. UPPLEME 0 TAL G©NSTRUGTtQN L M1t W INFOR TION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 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 forany 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." Signature of Owner/ Lessee/Contractor Agent for Owner Signature of Contractor/License Hold STATE OF FLORIDA STATE OF FLORACkA COUNTY OF � , LU(I,1f . COUNTY OF _ ��► f The firgoing instr ment was acknowledge before me day 20 by TheAr Wing instru ent was acknowledge¢,before me i cs day 20�' by this;[ of k(3 of ���i0 tiki�k Name of 0Vr9dd Making state Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced 1 Produced ' (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commissi N I E �S@ KAREN S. NIELSEN Co s$1 l$Jq. ( al) 9:° `s. State of Florida -Notary Public g�° `a'_ a e o on a- otary Pubic ' •_ Commission H GG 207484 "sn 5 Commission p GG 207484 "'„0�,1°�S Y om Ju isslon Expire a June 12 2022 REVIE PERVISOR P MANGROVE COUNTER R EVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.