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HomeMy WebLinkAboutBuilding Permit Applicationr All APPLICABL INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1 O Permit Number: Date: RECEIVED �. Building Permit Application APR 12 2021 Planning and Development Services rnrmitting Department Building and Code Regulation Division SL-. bucie COuntl 2300 Virginia Avenue, Fort Pierce FL34982 Residential +✓✓// Phone: (772) 462-1553 Fax: (772)462-1S78 Commercial PERMIT TYPE: _ Address: /e5 S sL.f✓ /0,'1Gi Property Tax ID #: 3 ( � l 3 vv�G Lot No. Block No. Site Plan Name: Project Name: � s % MEN - _ r �L`a� t�''a,z 'ti-- x �`z�"•^.� y�- - "� .. Additional work to be performed under this permit-check all that apply: Mechanical _ as Tank Gas Piping _Shutters =Windows/Doors _G _ Electric _Plumbing _Sprinklers _Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 3�0� Utilities: _Sewer _Septic p Building Height: i-,..'�.?T'!T`^WR &6`Ye_^ - rE sF q -�'. —1 5�00%-- `:k AP MAR 4Name Name: Address: 7�� `��' S I Company:- City: % �� ///�'�-C/ State: � I Address:. Zip Code: j zrlo Fax: City: State: Phone No. // �- �©�6 ` ���o �— Zip•Code: Fax: f7 E-Mail: C lyl eh-.5 Phone No Fill in fee simple Title Holder on next page( if different E-Mail 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 structure.Please conlict sth any ult with applicable Hlome Owners Association lon rules;and reviewylaws or and your deed for any covenants restrictions t o s hat wh chtrict or may al .prohibit such 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 per 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 "VYARNING TO OYYNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIQN. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 4Signqature �6w`ner Lessee ractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �' COUNTY OF The forgoing inst me t.w s acknowledged pefore me The forgoing instrument was acknowledged before me this J day of 20 `�,,1 by this_day of , 20_ by Name of person making statement. / Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifi atTtm Type of Identification Produced Produced (Signature of I ¢" (Signature of Notary Public-State of Florida ) ,a;P, , I<AR�_N N ELSEN �B,�,State of Florid Notary Public (Seal) Commission N� - _ fission 207484 Commission No. 1� Y.. My Commission Expires June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS I VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.