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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Numberol© l�� 0 q�o' Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: Address: j-q© b Property Tax ID #: Site Plan Name: Project Name: RECEIVED AUG 2 7 2021 Building Permit Application 0f WOO County �'t?fmitting Commercial Residential Ir Additional work to be performed under this permit —check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters ✓Electric ✓Plugmbing _ Sprinklers _ Generator Total Sq. Ft of Construction: / Pol Sq. Ft. of First Floor: Cost of Construction: $ �_ S, P O V Utilities: —Sewer —Septic Lot No. Block No. Windows/Doors Roof Pitch Building Height: OWNfR/LE-�55�EE:� C©WIT RA TOR: Name - Name: CCo� Address:„Com.pany: It IQ �G State: � ss: Y City: State: TZ Zip Code: v Fax: ti Phone No. Zip,Code:,. Phone No ' .,Fax: �= ( • b E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail State or County License `S 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. 5 . DESIGNER/ENGINEER: Name:_ Address: City: Zip: Phone Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: State City: State: 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 ITE BEFORE THE FIRST INSPECTION IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH UR LENDER R , ATTORNEY BEFORE RECORDI G OUR NOTICE OF COMMENCEMENT." 1&4 'A_ C_ 4-) t L". N-1 Signature of Owner/ a see/Contractor as Agent for Owner - nature of ractor/License Holder STATE OF FLORA` STATE OF RI A COUNTY OF J`1 c e i.Ri � COUNTY ��t . (�rJ\C,N• fore me The ofgoing instr ment was a kpowledg�t1lb It The forgoing instrument was acknowledged before me this day of t 20 y this n day of C 20ak by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Kno OR Produced Identification Type of Identification Type of Identificati n Produced Produced We Of Ftarida PO Notary I Jones r (Sig ture-of Notary Pblic- St ua)e of Florida) (Signat - f Notary b i take ° 1 rAp23 Commission No. P� Notaf$ �%StateafPlo6da Commission No. 4an a) c : Dany o 352016 Mly commissionG3 4a •p REVIEWS FRON SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.