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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED Building Permit Application JUN 01 2021 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 St.Lucie County Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential Property Tax ID #: 3� +��1 dam d0(ZA_O 4V Lot No. Site Plan Name: wy4- Block No. Project Name: L O" t - �- Ff�,,•,.� � �.'��� i -i-s5.-. � q`.c><. �. �'�.,�5.q' � � -. � v #.� � ram- rA � Additional work to,be performed under this permit-check all that apply: l Mechanical _.Gas Tank _Gas Piping _Shutters _Windows/Doors `Electric _Plumbing _Sprinklers _Generator -Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: Utilities: —Sewer —Septic Building Height: 4 -��Y ems. �,$F..?Fe N-}�i 4v.�i` .S� S $-fi 2 � �",..�u�'�i. _.trw,-,'�,.� Name Name: Address: �'� ©l�.e>ztft/ ` Company: City State:L�� I Address: ?/j3/, ' /A-4( -c ��i 5i G21 ZipCode:, - T..:. ... �- .952-- Fax: City:. P%(TGtlG/w : Statei Phone No._73� Zip Code: 7�9k Fax: E-Mail: Piione'Na::' ' Fill in fee simple Title Holder on next page ( if different E-Mail /"�;4&1 5 (7. 1_36c -So14T-1-1 ,/Vf_! from the Owner listed above) State or County License .23_ 5,-!7 � Y r O 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. 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 Applicabfe 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 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, accessary 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 PAYIIIG TWICE FOR IMPROVjEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Sig re of Owner/Lessee/Contractor as Agent fo Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 1.Uc COUNTY OF S�• �-�c.� The fgrgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of \� O t\e 20a1 by this day o ` 20r1 by Name of person making statement.. Name or person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of IdeqAtication Produced �_ 9 L Produced -01 (Signature of Notary Public State of Florida) (Signature of Notary ub�"" ;•ate of Flo GIVENS f?°��ti�` Notary Public-State of Florida Commission NoAV\0A $' .., (S��,ZG Commission No. A Commiss(�iiftI086359 2°• �,':. Notary Publ =forida y Comm.E*res Jan 28,2025 F` Commiss359 Bonded through National Notary Assn. y omm. REVIEWS FRON ough ry Assn. PLANS VEGETATION SEA TURTLE MANGROVE COUNT R REVIEW 'REVIEW REVIEW ' REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.