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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Tlpc� 2�Sboa d Permit Numbe , RECEIVE® __ Building Permit Application OCT 2 6 2020 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: Address: 7Y66 W,k-kr Gam, Pa, Property Tax ID #: 43 a �" dais -68 Site Plan Name: Project Name: K� r,-r--c-e- Lot No. Block No. CI'., F 1 rN1 A M U.A J rui h l'o OA rt� 6,n ri V'A I f lam- p ph io tv ( n �1ag12� t',ec �Ca�� : �Irc�rt- 4 -sues -t- r�r u 9 cr-L"e- Qte a+ v lot Additional work to be performed under this permit -check all that apply: n e�v',� _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: $ Utilities: —sewer —septic Building Height: QNSEE: NEW CONTRO T©R: Name ..Name: Address: 7`!�%� 6aSn Pr_ 61_&- ^ ar�w'� Company: City: '(�} . }%�a-. Cat- State-: Zip Code: 10 Fax: Phone No. 7 }- - 7-��I Address: City: State: Zip Code: Fax: Phone o E-Mail: ah"AA ' Fill in fee simple Title Holder on next page( if different from the Owner listed above) E, Mail State or County License.: - 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. DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: I FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: I 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. ermit holder to build the subject structure St. Lucie County makes.no representation that is granting a permit will authorize the p which is.in conflict with any applicable Home Owners Association rules, bylaws or and (Icovenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed fdr any restrictions Which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, lin 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 BUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOT ICE. OF COMMENCEMENT." Signa a of Owner/ essee/ ontrac r as Agent for Owner Signature of Contractor/License Holder 'STATE OF FLORIDA STATE OF FLORIDA COUNTY OF _COUNTY OF' ' The forgoing instrument was ackno"wledged before me The forgoing instrument was acknowledged before me this day of / 20�by ir this day of I 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced 01 7xa�_,�u Produced —JAL (Signatu e o Notary Public- S a of Florida) �� Signature•of No6ry Public --State of•Florida )' Commission No. (Seal) Cr a Ommission'No. (Seal) DZv o cca�—� 'REVIEWS FRONT ZONING SUP �� 2 . LAN$, V.E.GETATI0N. SEA TURTLE' MANGROVE COUNTER REVIEW RE l�v� VIEW REVIEW REVIEW REVIEW DATE _ o RECEIVED DATE ; m3� • e¢ ., COMPLETED =� —