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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCE - Ii) Permit Number: Date: SCANNED Building Permit Application Planning and Development Services St Lucie Counfv Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1S53 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: Address: T Property Tax ID #: Q3' — 01)6o © (9 Lot No. Site Plan Name: Block No. Name: Project i n ��: ads ar Y__m Will! f Ay l •. .� .-�' 4CV7 '5"�j.-q `w y_S-B>•�,tq '�} Yx.� � 1 "�?l,.s� �£i Y�`i 5 �c�i �� ��-��# ��f`153� ���s�� E�� �� YES. h �-'y^t, :> -. f�i>ll�IV^"'+�i,?iYi'V1 �•�. .r �l r.-Mom`"'_. F z�. ua12_.�-3.r-r•_�.txra..r��s? ',._-,".a gked�F• -tea.. °L- Additional work to be performed under this permit— check all that, apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator — R6o'f Pitch Total Sq. Ft of Construction: O Sq. Ft. of First Floor: d Cost of Construction: $_� Utilities: —Sewer —Septic Buildingg Height: --n- rt:rrk:e.�a � LLI '�.y .., v.w ;•ram �s a "Egws'K� � � c r "e:a�.�wq l $�•da�i¢• - �L:"6��^� �5+w'�__ Z��'� AC �-iz aYJ1W •�' Y�� ce5! tName Name: ; Address: I Company: r I City: 1-- State: r ` Address: I Zip Code: Fax: `-C �� // Phone No. �o� o� 1 e 5 Y: State: City: Zip Code: Fax: E-Mail: 1.LCo 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. I DESIGNER/ENGINEER Name: Address: City: Zip: Pho FEE SIMPLE -TITLE HOLDER: Name: Address: City: I Zip: Phone_ - Not Applicable State: — Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: AririrpcS: City: State: Zip: Phone: BONDING COMPANY: Name: Address: rit Zip Phone: Not Applicable 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 reprl sentation that is granting a permit will authorize the permit holder to build the subject structure swhich is in tructure. Please consult any with yolurHlome Owners AssocAssociation ation andrreviewyyour deed or any -restrictions nts whichtrict ormay al. prohibit such 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 OYMER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT W YOUR PAYING TWICE FOR IMPROVEIj��iENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB ISITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER QR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." urd/oY owner STATE OF FLORIDA COUNTY OF ractor as Agent for Owner The forgoing instrument was acknowledged before me this _day of I 20_, by Asa Chi Name'of person making statement. Personally Known Type of Identifica Produced �Vo— OR Produced Identification rn L.- (Sigof I, - eat saildx3 uolssn.uu�oD om i d�W4'a11 E)C # uolsslww0 a ollgnd Aiei�eFn° iS iJ�a4d Add NH9nvA N3��3 REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED ev Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me this _day of , 20_ by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced E L L E N VA G 'ate- �f =omm. �o a.(Bi&13pj of Notary Public- State of Florida ) MY Commission EV20 ,October 22, pimert�is n No. (Seal) SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW