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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1 LJ ` ©O��I /qunoD apn-I -is ;uaw;jeCaa 6uI;4IwJad - - Building Permit Application Laoa s o ads Planning and Development Services 43AI9DDId Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: Ma ems. zc- E,- r{I '' 04— Address: 0 6 �/ I✓�1 S L L/S PropertyTaxlD#:—``��l���S'�a`�5— O<SO �� Lot No. Site Plan Name: Block No. Project Name: � � , - z s*�, ..�.�.,�nz �a-�'�'��,� g� �' ''s�•al-� �"';,fs^ �'`'- _,.� ;...tom k,.,� i �^''��-+� ''R -K 3 �, ,s�[�''- �a ._.r^-�7 -._s a -"` t ��.. =-t. ..,i �-� •�"�...- �-#,.e -. � �- r:� _--� z, �y`_. ������r �� �,. Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator '-Roof Pitch Total Sq. Ft of Construction: (LUZ) Sq. Ft. of First Floor: I�I� D Cost of Construction: $ � �°Q Utilities: —Sewer —Septic Building Height: /U �44 {r -' '4 " .,` '•s. , •I,g �"-.,�- -Mre_: - ,�ti, d::a"z'„ _r.. s - _z.cam i�..r, .•x�--�.,.:s"'i..iic�.,. ��`<�a.-.4^T`a:.a..-?-�s .ux"��0, ,•ism f..���-r.�.-F�-u'�i... _ _�s..Xr .��'�^.�..,'�.�r-._.�.,_ _�'�. Name Name: Address: 'lye /0L 'SE�Ll Company: / �'1 •fit a �• City; State: r Addr"ess: a GCrl df// Zip Code*: 3 / > I Fax: {City: 1--ef" State Phone No. 7�y d-� s' ��.�`� Zip Code: ��/ � 6 Fax: E-Mail: Phone.N Fill in fee simple Title Holder on next page( if different E-Mail 47V 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: Name: Address: Address: City: State: City: State: Zip: 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 ITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR N ATTORNEY BEFORE RECORDING YOUR N CEO OMMENCEMENT." Signature of 0 /Lessee Contractor as Agent for Owner Signature of o ractor/License Holder STATE OFF RI PA STATE OF ORIDA COUNTY O � ,L_ COUNTY F The forgoing instrument was acknowledge before me The fo going instrument was acknowledged before me � by this day of tl^<1� 2A by this�day of'{ha�( tides Name of person m king statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary P lic-State of Florida) (Signature of Notary�blic- tate of Florida ) NA o3rJ v5 Commission NoN_6� (Z 71. (SeabEANNAGIVENS Commission No. GIBE e'"= EA AState°f ca =?°� ��; Notary Pubiic State of Florida °U •: Notary Pubiic'w Hii 086359 5 �� o` Commission;HH 086359 :Z <: ° fires a oFt+.:' My Co m.Expires jan 28.202 o: mm,Ex tart Assn' hro g t REVIEWS FRO y ••`zO I �ughN ti 1 PLANS VEGETATION SEA T�A4 ��' rAss . COUN R REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 1,7/11