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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO.MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r `' Date: Permit Number. O 1� " ► RECEIVED Building Permit Application Planning and Development Services NOV 17 2021 Building and Code Regulation Division St.Lucie County 2300 Virginia Avenue,Fort Pierce FL 34982 P itting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential T PERMIT TYPE: PROPOSE© IMPROVEMENT LOCATION: Address: 131-10E&R AtlF Property Tax ID#: ) 30 " to 0 2-(.eO- 0.(50-'3 Lot No.12 Site Plan Name: Block No. 1 a Project Name: DET" )LEA DE�SCRIPT�C�1N a WORK: RCj'GA�E EY"if1,R( Z;(SIT .901F ul :'rH F/l=w PHE AND CnMF,-T Jldv EIC-4Me 44c.c -ro ;i )ALIAS c J%r Moire! rr CQNSTRUCTION N'F©RMATCON: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters' _Winrdows/Doors ' ~ Electric _Plumbing _Sprinklers _Generator. ; Roof 'Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ / IP0, Utilities: —Sewer —Septic Building Height- ON R!0:1K@ SASE ; CONTR00"' : Name VLQWt RAII-Ir Name: . Address:/201 PEE EAId AVE Company_: ' City: FT. 6c-lec Stater Address: Zip Code:-?yV/ Fax: City: State: Phone No. 7)2-2 991- /fig Zip Code:_ Fax: E-Mail: Z,6(4 Rk 7-9 9TH 6S' R b(ASOUT1) . IV Er Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License 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 C«CINSTRUCTCON LC N LAW I�NFUftMATCC?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 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." Signs ure Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License.Holder," STATE OF FLO IDA STATE OF FLORIDA COUNTY COUNTY OF OF The forgoing instrument was acknowledged before me The for oing instr rent was acknowledged before me this day of 20_ by this A day of 10V 20� by Name of person making statement. Name of person making statement. / Personally Known OR Produced Identification Personally Known OR Produced Identification ✓ Type of Identification Produced Type of IclentifiiaZign Produced . 1, Signature of Notary Public-State of Florida) (Signatu e of Notary Public-tSta�telfo ommission No. (Seal) , KAREN S. NIELSENCommission N0. " a<<;Sta(5eeflylorida-Notary Pub is =* *= Commission.# GG 20748 OR - My Commission Expires nim REVIEWS FRONT ONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19