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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMA a -fED FOR APPLICATION TO BE ACCEPTED ��� Date: 610VI911� Permit Number: l �" SCANNED • BY FER 14 2619 ..-fibula iWfiCountformittlno0ape�ant Building Permit Applic Planning and Developmnt.S&tces m % = -_: 3L Lucie County b Buildin and Code Re u ahon Divisiori x �' ix 2300VirginiaAvenue, Fo 'erce_FLi34982'.;^..Y,t?' i l:> Phone: (772) 462-1553" Fax: (578-1i_L"MCOm f nerClal Residential PERMIT TYPE: PROPOSED IoM��P/IROVE,M' E/NT LOCATION: Address: gac+`/ I�2tC7ru�olc�ii lei. OGkQi-�7�lUe�e, �� 3�/��� PropertyTax ID #: Lot No. Site Plan Name: Block No. Project Name: SP1,,VAW AS IPI /OdC GOB D ILED DESCRIPTION OF WORK: CONSTRUC«1'ION INFORMATION: Additional work to be performed under this permit -check all that apply: 'I/Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Electric _ Plumbing _Sprinklers _Generator _R000f Pitch qq Total Sq. Ft of Construction: af-�I Sq. Ft. of. First Floor: XJ O Cost of Construction: $ Utilities: —Sewer _Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name /� mod Name: gA�Q�1 Address: rota/ �0k���Q%�� �% Company: City: _57/ Stater Address: City: State:_ Zip Code: �/d��6 Fax: Phone No. ��� 6'�©���� Zip Code: Fax: E-Mail: cuu'6CiuoY� @ �%gdt2G �. tan Phone No Fill in fee simple Title Holder on next page (if different E-Mail State or County License 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. SUMMEN AL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 priorto 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 LENVM OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Owner/ Lessee/Contractor as Agent for Owner naZIF Signature of Contractor/License Holder STATFLORIDA STATE OF FLORIDA nn���" COUNTY OF vgf i (i(iAi. COUNTY OF The f r oing instrumen was acknowledgerkbefore me this _ day 20tY by The forgoing instrument was acknowledged before me this day 20_ by �o_-f.p� nA 8,04 Ath 1w _ of . Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific ion Produced tL �yl'.It Type of Identification Produced ^ - Aahhw J= - �ofl1 ln/IIy (Si nat re tf Notary Public- State/of Florida }}�— (Signature of Notary Public- State of Florida ) Commission No. ggt1MWG Commission No. (Seal) �'e =E�' ►1YCOI+IMISS REVIEWS FRO '' s; 2 t PLANS VEGETATION SEA TURTLE MANGROVE COU W REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE E49E] COMPLETED Rev. 1/ // ly