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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMP(-- `..FOR APPLICATION TO -BE ACCEPTEI? Date: U'' �) Permit Number: ECE` Building Permit.Appiic 2o1s Planning and Development ServicesBuilding and Code Regulation Division Ftment 2300 VirginiaAvenue, FortPierce FL 34982Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R=ounty, FL PERMIT TYPE: ,� 1IYyJ Address: 2 2- a` d Property Tax ID #:0 0 460 ` © o /0 Lot No. Site Plan Name: ttlk h Lo S m M Block No. Project Name: �C �`� S C, µ — A/8 t4- '7 vo%z ,-W> yy zY"."Y Additional work to be performed under this permit— check all that apply: ''f echanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors electric -CZKI Umbing _Sprinklers Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: c% Cost of Construction: $ 6 Utilities: —Sewer —Septic Building Height: Name ' ' / Name: �^°4 �-e �K� Address: '3Z OO 470 Company: City: �_� vee_, State: _ Address: I 11 1d!'f_Z Zip Code: 3Vr149Fax: 77T�/O7—Y.?2 -A City,`orYe O _r ,�� State:me^' Phone No. "772 ) Yy 7— Y 326 Zip Code: Yi/47 02. Fax: E-Mail: Phone No ?�>,2— , Fill in fee simple Title Holder on next, page ( if different E-Mail " 0 r from the Owner listed above) State or County License If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name ?4J0W01 _ Name: Address: 9' r,6La3. Z2e Address: City: ,�. S-L" Z.,4,0, Stater City: State: Zip: gyi3 g$ Phone _ Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT PATH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' not ,• e o . or/License Holder grill e ne essee/Contract as Agent for Owner STATE OF FLORI STATE OF FLORID COUNTY OF COUNTY OF ` The f9jg�oing instrument as acknowledged before me this) day of �% r' , 20 by The fro g instrumgniwas acknowledged efore me this Y day of 1�/ , 20�by Name of person mak' sta: a ent. Name of person making,st tement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identif tion Produced Hat- Type of Iden . ication g Produced lll�/Y. 9 r 'gVnj„ .U--, /2Z/d (Signature of No - (Signature of to Pub*Stateof F rida l Y Pu AUDREY B. HUINPHREY Commission No. MYCOMMIgSL4PGG300817. EXPIRES: March 6, 2023 ----_ Commission N °' � AUDREYB.HUP�iP�I��Y =•: ;*= MISSION # GG 300817 ' ^ :E o �°; ded Thru Notary Public Mrs ' .s EXPIRES: March fi 2023 on ed Thru Notary Public Un erwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETAT1 W ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19