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HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I"5-2021 Permit Number: - ft* ItO v.. Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: Ol `- , Ui ding Permit Application Commercial Residential I/ PROPOSED IMPROVEMENT LOCATION: Address: 3 Property Tax ID #:J N - 501 - CO3 5 - OUO n Lot No. Site Plan Name: Block No. O Project Name: law A,w t nce H DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to be performed under this permit - check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _Electric Plumbing _Sprinklers Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor:_ Cost of Construction: $ 106L! , Utilities: _ Sewer _ Septic Windows/Doors Roof Pitch Building Height: OWNER/LESSEE: CONTRACTOR: Name e H 1 �' Name: Cam/' Address: G) n n City: ?i If \ State:. t Zip Code: �))q I I Fax: Phone No. � - -y Company: Address: J City: State: FL Zip Code: Fax: - Phone No -� E Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E Mail (D Qcon State or County License nass� 11 VGIUC vl W11 ZILIM. LIU[1 1];)1 JUU Ur more, d KCLUKUCv rvouce OT LOMmencement 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: _ 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 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 O AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO CEMENT " Signatu e clOwne Lessee/Contractor as Agent for Owner Signature o Co tracto License Holder STATE OF FLORIDA D COUNTY OF 1 C1 �W 1 Qaop STATE OF FLORIDA COUNTY OF @ The forgoing instrument was acknowledged before me this 5 day of 20� by The forgoing instrument was acknowledg , before me this _ day of Jnn )b_ 20j by _I Cvin G;)Ioa') y�ew�n 0)luuM Name of person making Name of person making statement. �staattement. Personally Known ►' OR Produced Identification Type of Identification Personally Known V"- OR Produced Identification Type of Identification Produced Produced /& f . # is t (Signature of Notary blic- State of Flori4at)ru©, THERESAJ c "` ° /� � <, Commission # Commission No. �' Expires us p 9 "to r1 ���\ Bonded Thru Budget 1, Rq ature of Notary Pu I' - State of Florida?��;"",8E A G 138843 �t w Commission (� �' Expires 2oission No. �" pAug°'=�� otary Services �'uF 103 Bonded Thru Budg.i REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19 BOUR 1138843 8, 2021 ary Services