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HomeMy WebLinkAboutBuilding Permit Applicationi All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: U ' \ a_,� Permit Number CO1 f � ©iL� RECEIVED • J DEC 0'9 2020 rr..r Building Permit Application Permitting Department St. Lucie Coun' 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 APPLICATION FOR: PROPOSED INPROVEMENT LOCATION: Address: H 1l - CAR ) 1'a Legal Description: Property Tax ID#: _ - Q Lot No. Site Plan Name: Block NO. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: r y a O/V Arck] t� turn f� ,gh r��l 5 Yf _ CONSTRUCTION INFORMATION: _ Additional work to b performed un ert ispermit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator #Roof Pitch Total Sq. Ft of Construction: Y,, Sq. Ft.of First Floor: Cost of Construction: $ �dv' Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name e Name: �(� l v. ' v� Address: Company: City: t State:F)- Address: Zip Code: 3425I Fax: City: State:4� Phone No. �D�- 3702 " ��� Zip Code: Fax: E-Mail: Phone No 7hi�e! /Y Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) State or County License C� If value of construction Is 2500 or more,a RECORDED Notice of Commencement Is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORIUlATI01. DESIGNER/ENGINEER: Not Applicable/ pp o MORTGAGE COMPANY. , f _Not`Applicable r Name: Name: Address: Address: City: Stater City: State: Zip: P Zip: o e: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COM ANY: Not Applicable Name: 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 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing ork or record'recordJng yo4fNotice of Commencement. i Sig a re f caner Lessee/Contr for as Agent for Owner Signat a of Contra or/License H er ST TE OF FLO D STATE OF'FLORIDA COUNTY OF t Ikki— , COUNTY OF The f oing instrument was acknowledged before me The' }� ging Ins ment w s acknowledged before me this�=y of r 20�by thisv` Z of - ' r 20X by do (Name of person acknowledging) (Name of person acknowledging) -LL2LL (Signature of Notary Public State of Florida) 1 / (Signature of Notary Public-S to of Florida) Personally Known OR Produced Identification V Personally Known OR Produced Identification L--" Type of Ide,� ►f� a o 2� / ,I Type of Identificati n . Produced 4cD� �LJtJ"�Q�I�a�4�� Produced (J�Z Commission No ZZOZ'6 g 3 ZZOZ'6 gad sandx3 wwa�/ :'E"' '. .• a saildx wwo�nW "' L�•., Zti JJ �-•••,. Commission No. � _� �. � �• LV901 JJ#uoolsslwwoo lssJwwo� _ 1�� a uo �o a e epuol J Jo alelS—opgnd tieloN , ��V ' R Ij. 1 1S—ollgnd tie;oN •o; ;a ANSlflls1U1.3 A REVIEWS ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014