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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLErry FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Applicati Planning'and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL-34982 Phone: (1772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: il Address: Residential SCANNED Legal Description: at LUde O��n+ur,rY Property Tax ID #: \3ON- C' \'0 �d'SO ' 4a0-5 Lot No. Site Plan Name: Block No. Project Name: Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: '6 Sq. Ft. of First Floor: D O O r Cost of Co nstruction: $ / 2:;, is a U Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRMR: Name'. G:: .12 rl►:%i% Name: _ Address:,- f!1 G'71�"TQ'�{ �✓�i�� Company:, ,d City: State:,,"/ Address: i Zip Code: City: State ,1Fax: , Phone No. 7 �} �� /y `— d %'/' Zip Code: G Gl Fax: E-Mail: i Phone No Fill in fee simple Title Holder on next page ( if different E-Mail State or County License C [,,7� from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 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 Count�yy,m,akes-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 consideratipn 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 oste I on the jobsite before the first in ction. If you intend to obtain financing, consult with lender o attorney before commencin ork o ordin our Notice of Commencement. er/ Lessee/Contractor as Agent for Owner SignrOF Signature oJF ev. SUIP ; LEM �NTAl, C • NS �1'I©'N !E (NFQR� TtON: DESIGNER/ENGINEER: � Name: Address: Not Applicable MORTGAGE COMPANY: Name: Address: City: - Zip: Phone: Not Applicable State: I City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: Not Applicable BONDING COMPANY: Name: Address: City: Not Applicable ' Zip: Phone: I ctor/License Holder STARIDA STATE OFCO �. COUNTY �� The forgoing instr m nt was acknowledge before me � � � The forgoing instrument was acknowledge before me dcb � thisl4 day of , 20 by this�G day of 20 by (Name of person ac nowledging) (Name of person acknowledging ) (Signature of Notary blic- State of Florida) (Signature of Notar Public- State of Florida) Personally Known OR Produced Identification Personally Known ti i ation Type of Identification Type of Identifica n,:�r;••••., pEANNAMARIEGNENS Produced Produced t417 N#GG022023 ��,,r;;,, •.,,, DEANNAMARIE GIVENo v,. EXPIRES: Decembor 16,3020 Commission No. � NIYCOM ^�Q�N#GG022623 CommissionN0. B ndedTtuuNotary�l�yndenwriters EXPIRES: 16, 2tl20 IoF d:'. Bonded Ttuu Notary Public Underwriters I ' REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 0 RECEIVED DATE COMPLETED