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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-11-22 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: r Building Permit Application J0. 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 PERMIT TYPE: �A)1 rL/ �o PROPOSED 1M PR OAR0,ENT LOCATION~ -�- Address: '.�D7 IV I A7 1. �) '( �✓G ✓��� ���, �7/ Z I .. Property Tax ID#: `��S' 7ol — y 16 -7 70 " Lot No.� Site Plan Name: .0 124 Block No. Project Name: IT- ©ETAILED ©ESCRI'PTION OF WORK: w w� '41 eie. 9-7 Pill- 0076 CONSTRUCTION I'NFO'RM WTI ION: Additional work to be.performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters I-I&Indows/Doors Electric —Plumbing —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: ^� Sq. Ft. of First Floor: Cost of Construction:$ 3000 e Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 64 �. � � Name: maf shai U Address: 7_ N Al `r%7 Company: 0gv'i . RJ �lctfSlIcu (( 3 . ,:City: =�I t7Gf'E[: � � State: Address: 00,f U -n'WAL J yc- "b r SC Zip Code: Fax: City:P cx State:}-L y phone No ...! , Zip Code:3c(4)0 qJ Fax: -Mail: Phone No RScI r- 3 Fill in fee simple Title Holder on next page(if different E-Mail Alm, i & o-4 f) e- f from the Owner listed above) State or County License C If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. SU ' FLE EN AL CONSTRUCTION LI,15N LAW INFORMATION• DESIGN ER%ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain'a-permitAo do'the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Countyy,makes no-representation that.is granting.,a permit will authorize the permit,holder to build-the subject.structure which is in conflict'with any applicable Horne Owners Association rules;bylaws or and--.cove`nants that may restfict_or prohibit such structure.,Please consult with your Home Owners'Association an'd review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work in accordance with the approved plans,the•Florida,Building Codes and.St. Lucie County Amendments: The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use "WARNING TO OWNER:.YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT -WITH YOUR LENDER OR AN ATTORNEY BEFORE'RECORDINGYOUR-' OF COMMENCEMENT.""."'.. C. Signature of Owner/Lessee/Contractor.as Agent for Owner ,*$ignature of Contractor/License;Ho.lder• , STATE OF FLORIDA STATE OF FLORIDA� 1 COUNTY OF LIC COUNTY OF l It e k C The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this day of 20_ by V 511� 1 Name of person making statement. Name of person making statement.k Personally Known OR Produced Identification Personally Known- , 0R.Produce'd Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public-State of Florida) (Signature of•Notary Public-.Stat o I ri Commission No. Seal �� v�� f _ ^;°< °'E "BEVERLY OIAHE MARSH _ (Sea]) Commission No. ?°; `Sel>)3ry Public•State of F a a y- �_` `Commission k HH 08219; '�o ?E` My'Commi.Expires Jan 19 5 or• e t roug a Iona o a n r REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SE G O E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED' DATE COMPLETED ev.