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HomeMy WebLinkAboutBuilding Permit ApplicationI All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVr-r% ._ Building Permit Application Planning and Development Services JAPI Building and Code Regulation Division Permitting 2300 Virginia Avenue, Fort Pierce FL34982 St. Luce Loun�y Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential k- PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: 2--7lv Property Tax ID #: �7ZS' %P Lot No. Project Name: DETAILED DESCRIPTION OF WORK: C S f !2 w cc CONSTRUCTION INFORMATION: Utilities: Sewer . Septic So. Ft. of First Floor: Cost of Construction: $ OD v Total Sq. Ft of Construction: FLOODPLAINfDEVELOPMENT PERMIT for structures exempt from Building Code that are in the floodplain: Nonresidential Farm Building: Temp. Bldg./Shed used exclusively for construction : Mobile/Modular for temp. construction office: Bldg. involved in distrib. of electricity: Other: Flood Zone: BFE: Floodway? Y/N If Y,. No Rise Certificate with supporting data attached? Y/N " All other applicable state and federal permits shall be obtained prior to commencement of construction. OWNER/LESSEE: CONTRACTOR: Name_ _..Uo,v Address: 2-1 City: )C::;r- P: B!2 a e-- State: Zip Code: -?-f 9 9�lo Fax: 772- �ee7— /3 4e Phone No. 777- — �ZP - 7- a of 9 E-Mail: d.X7,- -e 4!!�? 6ePOc®,.� - .vim Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: �/J�, Company:-Aov 11,�,k% f Address:_ Z/ v�-- City: ITT �� eves ti State: F` Zip Code: 3if ftf Fax: 7)7 - 41e(o ?_13L Phone No 772- - ,SZd'-Zz 5-4E-Mail cLk:4 ��@ T State or County License C_ z/40 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: &41-12-7 Addrel v-e— City: State: Zip: Phone U5-- 2 KS- 2 3 3 `! MORTGAGE COMPANY: of Applicable Name: Address: City: State: Zip: Phone: —T FEE SIMPLE TITLE HOLDER: mot Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: Applicable 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF zlCOUNTY OF 'Sk The forgoing inst ument was acknowledg before me this AL day of 2 by Name of person making statement. Personally Known `-� OR Produced Identification Type of Identification ©IRSai..T of Notary Public- State of Florida ) Commission No. REVIEWS DATE I RECEIVED. I�1111 DATE COMPLETED The forgoing ins ment was acknowledged before me this 4— day of 20� by Name of pers n making statement. Personally Known OR Produced Identification Type of Identification Produced -TSighature of Notary Publ' Commission No. .� :•_e�1 L7lF�.FF ��PO' pW wu PLANS VEGETATION SEATURTLE REVIEW REVIEW REVIEW MANGROVE REVIEW