Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO'MUST BE COMPLETED FOR -APPLICATION TO BE ACCEPTED Date: -"1' l b'� Permit Number: o©i?) 1 I1 - © 2,0 a - - REGI=Im - - Building Permit Application I11, 1 0 m Planning and Development Services - I Building and Code Regulation Division 3l 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ok Residential PERMIT TYPE: [PROPOSED IMPROVEMENT LOCATION: I Address: Property Tax ID #: c] �ZZ 'rso oape oaz) % Lot No. Site Plan Name: ProjectName: #n&,T/ep PCs Block No., I DETAILED DESCRIPTION OF WORK: I ReAl.ac2 w all -Ttenv zae cz- C1i�aT�.✓ CONSTRUCTION INFORMATION: Additional work to'be performed under this permit- check all that apply: _Mechanical Gas Tank _ Gas Piping _ Shutters —Windows/Doors A! lectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: .11q. it ! Sq. Ft. of First Floor: Cost of Construction: $ = L99 d . Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name .hR {firma 1/1S0-4 C,(1aS-fL44 AZof Name: zw Address: /i111 7— c1R Company: Ff "'P!1 �l� Jul Go✓S City: CbUhA ( C.,o b T-ef _ State:F1 Zip Code: Fax: -Phone No. 3e.5 64 -./Yfl Address: 44-' 21e 5-79 Si' City: lfiU�ij State Zip Code: 33Y07 Fax: Phone No Ste/ 8'D N2 SF2 E-Mail: Fill in feesimple Title Holder on next.page.(.if different from the Owner listed above) E-Mail 0,�w.v 1& Fe'yrP 14/S14,V.S • CJrg , State or -County License^ j = S D QCW / V D If value of construction Is $2500 or more, aRECORDED 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: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable 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 Countyy 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 YOUR LENDER OR AN ATTORNEY. BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of STATE OF FLORIDA COUNTY OF The forgoing instrument this _ day of Name OR Type (Signature of Nota Commission No. _ REVIEWS I FRONT I ZONING. COUNTER REVIEW RECEIVED COMPLETED for Owner rS�ltia#iieofiConfGactor/License Holder STATE OF FLORIDA COUNTY OF�a/A�&6A before me The forgoing instrument was acknowledged before me by this _day of / 20_ by Name of person making statement. ntification Personally Known ;,� OR Produced Identification Type of Identification LLE 0§f�°ram) DANIEJEANHM WCOMMISSION#GO (Signature of Notary Public- Stat ° Commission No. `ie eall�IRES:May23,2 Thru Notary PuMlc Ur SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW