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HomeMy WebLinkAboutBuilding Permit ApplicationT - All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �Ra-;z RECEIVED permit N Date: APR m 6 2021 F s Peemitting Department St. Lucie Cous! Building Permit Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982. Phone: (772) 462-1553 Fax: (772) 46211578 Commercial PERMIT TYPE: Residential Address: / ca G J f jel c, V s.3o a110 _d®©_j IProperty Tax ID #: .� Lot No. � �� [p Block No. 5q Site Plan Name: Project Name: x Additional work to be performed under this permit— check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Pitch Electric _ Plumbing — Sprinklers _ Generator — Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 19 Utilities: —Sewer _Septic Building Height: Name aLJ1114AT 0 ���w'I V Address:J�,�/ &et/4, l gyeevve City: �C/U,c State: +CL Zip Code: 3��1 �� Fax: Phone No. �7r E-Mail : U e5U/ Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: Address: City: Zip Code: Phone No E-Mail 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,S00 or more, a RECORDED Notice of Commencement is required. Fax: State: DESIGNER/ENGINEER: — Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applica ble Name: Address: _ City: ' State: Zip: Phone:. BONDING COMPANY: _Not`Applicable Name:_ Address: City:_ 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 EIItST INSPECTION. IF YOU INTEND TO 013TAIN FINANCING, CONSULT ".tvy nrer.or o9:VnDencam. Yna IMP NnTiriF OF COMMENCEMENT." WITH TIYUK Ui141LIEK UK Alm Pk IUZUEv-, D *... e of Owner Lessee/C ractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instr ent wa acknowledged before me The forgoing instrument was acknowledged before me this _U day of 20W by this _ day. of 20_ by W 11�18M t1"b t Name of person making statement. Name of person ma <ing statement. / Personally Known OR Produced (Identification V Personally Known OR Produced Identification Type of IdentifiemSon Type of Identification Produced Produced I` i (Signature of No ary Public- State of Florida) (Signature of Notary Public State of Florida } Commission N Commission No. (Seal) `tiPpY1111' <AREN S." NIELSEN ;�° ;State of Florida -Notary Public REVIEWS v o �'%f�Pf ANT My mission OPj 'lR, 202 07484 �' E ISOR PLANS I VEGETATION SEA TURTLE MANGROVE W REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/ // 1y