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HomeMy WebLinkAboutBuilding Permit ApplicationI All APPLICABLE INFO MUST BE COFvir�c'TEID FOR APPLICATION TO BE ACCEPTEL,.: Date: -=J2 Permit Number: REC,51VIE-D SEP 2 7 2019 Building Permit Applicati R. Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 41-1 PERMIT TYPE: Address: -y�✓ge-Xq Dr FOrTP.,erc'e EZ� Zfe. 2 r,operty Tax ID#: q6 a Lot No. LI Site Plan Name: Block No. Project Name: BURM 90GR+IPTION OF MMIG —e- z V., C©NSTRUCTIO IN =RM AM Additional work to be performed under this permit— check all that apply: JL/Mechanical Gas Tank Gas Piping Shutters" -C/Windows/Doors L/Electric fY.Plumbing Sprinklers Generator Rooif Pitch Total Sq. Ft of Construction: 4 -2, Sq. Ft. of First Floor: Cost of Construction: $ Utilities: Sewer 1/Septic Building Height: OWNERITIQC;T @ 60 16 16 Name c;X 4, rol Cr/ X6a ')j Address: e �e 0 4C 3� r,�, /V eoz po City: 1F0tq Prl State: FL Zip Code: Fax: Phone No. 3,V 3 ''iAdd're'ssi'* State: Zip Code: Fax: E-Mail: Phone No Fill in fee simple Tit older on next ae ( if different E-Mail State or County License from the Owner listed above) 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. DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable. Name: Address: City: Zip: Phone: MORTGAGE COMPANY: NoApplicable Name: ft o S' a �.- /L Address:,./q City: w c/v State: Zips; 3W Phone: 6E: MY 0C2-S--/ BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDAVIT: 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." re of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF �1 The forgoing instrument was acknowledge before me this �' jday of 20_/j by Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me this day of , 20_ by OMM-d- /3 Ch -C 0,-A0 -n Name of person making statement.' Name of person making statement. Personally Known OR Produced Identification L__ Type of Identification Produced �i DVICl'6 �L 0�k#1fZ1 t"Lzlh HASShA SANABRIA f -Hair (Signature of Notary Public- t� as rIprlOd o 1UU11L missior r GG 340327 ary'` My Comm. Expires Jul 2E. 2023 Commission No u1y�8, Z3 Bonded(deaj6h hatiorai notary Assn DATE RECEIVED DATE COMPLETED ev.2/7TES valldaft Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida ) Commission No. (Seal) IT ZONING I SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW