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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED' a Date: Permit Number: U 7-' ' RON - Building Permit Application Planning and Development Services Building and Code Regulation Division Mt, 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial esiaI PERMIT TYPE: tI�R(�f�O�ED;tf�tlf'>�tOUEf�IENT I:�CATI0�1I r r # `- -� '�3 ".^ r � �•�-- C yz �,x r x A ���.* �'S �f Site Plan Name: Block No. Project Name: D NLED L?ES�CR[PTION QF 1t1# ?RK€ -� - iw�+• �, S�iL ���a y1 rtl/ i°1 q�u �� ( l ��Gy�N✓�.� J d+ r/js �dP" f e+''ty �'i' A/QOd''y'7 -cow,I1 �fW �� 6 l��i�lC7LrdN Y' t1Y1ol rep din 'ZT©pE b`l� LIG,ry .e�+y��-v_ S- e ev1- ,,VLeHi .SAow'+V WO N 'T'+ / aP'? !Addi'+� F 4 �.flbIe, p+li �z hcf,y t Additional work to be performed under this permit-check all that apply: _Mechanical �<l Gas Tank Gas Piping Shutters Windows/Doors Electric umbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ , 9�0 o V N Utilities: _Sewer _Septic Building Height: Name U1 C Q%r T N ClVC4%rra Name: Address: C19YO' QC-0-0y) 09% :0,5 0 Company: City: Tens e3 VN 1sec,'C h State: Address: . Zip Code:3Y Fax: City: State: Phone No. 3CC 33 i G� G? Zip Code: Fax: E-Mail:1116r—w-XAV C¢hCj� .co yv% Phone No Fill in fee simple Title Holder on next page( if different E-Mail from the Owner fisted 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, .,..��-����.r.�f� '��:>:a •E'."�,s �.��c-a �.�La'1r�F..-_ rr....,����� _ - .�cmcr. 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 SITE BEFORE THE F!RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOkrDiNG YOUR NOTICE OF COMMENCEMENT." Signat r of Owner/Lessee/Contra or as Agent for Owner Signature of Contractor/License Holder STAT O LORIDA STATE OF FLORIDA COU TY r S LG'Ci-r- COUNTY OF The forgoing in ru ent w acknowledged before me The forgoing instrument was acknowledged before me this�day of 20� by this day of 20_ by V1 Name of person ma n statement. Name of person making statement. Personally Know R Produced Identification_ Personally Known OR Produced Identification Type of Identifi tion Type of Identification Produced �' U.4� Q Produced (Signature oof Nota (Signature of Notary Public-State of Florida) Notary Public of Florida Commission No. tt Kimbe� Commission No. (Seal) ,1 • My Commiaf�on H 12543 a Y Expires 04/01/2025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 1 i I DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applica ble 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 SITE BEFORE TIME FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ' _ I �n gnature of Owner/Lessee/Contractor as Agent for'Owner Signature.of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S C_. u GR COUNTY OF The forgoing instrument was',acknowledged before me The forgoing instrument was acknowledged before me this I(-)Jay of 20C21 by this_day of 20_ by Name of Yersbn making statem Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification �- Type of Identification Produced cn_ Produced ho (Signature&AoTarY Pub (State of Florida) (Signature of Notary Public-State of Florida ) I Commission No. Commission No. (Seal) ,���tPAY PtiB�� E L L E N VA U G H N _State of Florida-Not + + rssron # GG 270079 REVIEWS F IV'i°+�i�"._�jN 'o mis i rUIJELXRW6C PLANS VEGETATION SEA TURTLE MANGROVE C tJN `ERs°' r`r REVIEW I REVIEW REVIEW REVIEW DATE J RECEIVED DATE COMPLETED Rev. 2/1/19 I I i