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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: PermitNumber: RECEIVED . Building Permit Application MAY 1-$ 2021 Planning and Development Services Building and Code Regulation Division permitting Department s"Luc a County 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PRO OSED I'MP Ou(} E •CA I©N. Address: 3')-00 P—C M 1 q()_)n)C Property Tax ID#:/�34 19-5-22-0 b)s"020 -5 Lot No. / Site Plan Name:Fg)YL AYS 5 5AVIMOA �Z.L� Block No.� Project Name: E TAILED DE�S�CR{PT JN �F WORK: 1 1 C` S� / �''� CONS RU TION iN -•Ft++MAT INN: 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 Total Sq. Ft of Construction:: Sq. Ft. of First Floor: *am truction:$ Utilities: _Sewer _Septic Building Height: LE�SSE C{•3N RACIT!V]I A ,A/-�.lLln j Name: Address: 2- ! Company: _z. h— city: =- State:��'t' . Address: /. l6 5S)- Z p.Code .��C�Z7� - Fax,:1,-- - - - — City: 4 . i zL G 4� State,:,IVCC Phone No.S-;0 z Zip Code? Fax: Fax: �I- E-Mail:' ���,j�r�,L-L,arr, Phone`No -2- Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License GA LE)7,10 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 LbEN LAW INftORMATION: 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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH UR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." p Signature of Owner/ essee/ on ractor as Agent for Owner Signa ure of Contractor/License older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The for oing instrument was acknowledged before me The fo oing instrument was acknowledged efore me this day of MKI�I 200�) by this day of mFgY 20o2�by Name of person making statement. / Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifi ion Type of Identifica' Produced Produced Y (� (Signature of No e of Florida) (Signature of Notary Public _ , `A�P', KA R KARLN $ +ELSEN .PAN S. NIELSEN Commission No. �2°�P Ue�=St vt Flori� �j�a Commission No. =_° _Stat �fl orida-Notary Public _. tery public - Commis ion # _� •; Commissi '� viF `` 14,1 on # GG 207484 i '�Forcoe` N1 GG 20748 OF FL° y �.Qri y Coii�mi June 12, 20.2 June ne 12, 2022 REVIEWS FRO T OR PLANS VEGETATION A COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.