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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECE1VE0 Building Permit Application jUN o 1zo21 Planning and Development Services Building and Code Regulation Division permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 St• Lucie C nh, Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: �G PROPOSED 6MPROVbMENT OCATI©N' Address: ( b lvl 5 W a L%, W % e Cjrf l_ 3 92. -V\6L\. $a-1- C)0 o-esCS(3 Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: DETAILED DE�SC«R,IiPTION ®f WORK: l� 9 c- b a i S s E t R IV �y T er wl o J-er R6,en, CONSTRUCTI©N INFORM ON ATI ; Additional work to be performed under this permit-check all that apply: \/Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing Sprinklers _Generator _Roof Pitch p Total Sq. Ft of Construction: t_yt -( of s M Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: OWNERJLE-�SSIL�E:"� CONTRAC OR: Name o a' W o e Name: u VK uvt Address: ((03 knq Wbe7� k Company: �� '� Co-K 4. '61 C City: wk%]'—c C-trf State:EL Address:157XI LtiVOV Zip Code: �r Fax: h p City: 6 - 5 . LP. State:-FL- Phone No. �}3,2 3j 4- 'I o3 O Zip Code: 72 -+i S-b Fax:: p E-Mail: Phone No 1-1 ;- 5-Xt _ 17®3 / Fill in fee simple Title Holder on next page(if different E-Mail C6(dVIV AC OR from the Owner listed above) State or County License C-PrC 1 8-( 17 R 35- 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. US,fti P,d'F.il I B M I R N F02 L CQNSTR+UCTION LIEN LAW INFORMM N; 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 roles,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 aWrespects,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 POSTE ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU ATEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N T CE OF COMMENCEMENT." Signature Owner/Lessee/Contractor as Agent for Owner Si afure f Cortractor Licens older STATE OF FLORIDA STATE OF FLORD4A COUNTY OFS3r.. COUNTY OF -6-Y- Ly t�@. The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day ofS V�� 20M by this \ day of 20a� by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced ) Produced L-p (Signature of Notary blic-State of Florida) (Signature of No ry Public-State of.Florida) Commission No. .���35 (Seal) Commission No. \01 a4%%35 (Seal) ' REVIEWS FRONT ZONING -SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER . REVIEW . REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.