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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEI'a.::'OR APPLICATION TO BE ACCEPTED Permit Number: 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:' C,gP,04.I ;�I Building Permit Ap Commercial fu _ ��1�1.� cati n MAR 0 5 2019 sr; 6uefe s�uney, permltti Residential C% SCAN 'P By Property Tax ID #: �7 �� �� — ©y b�. (9 U) Q % Lot No. Site Plan Name: Block No. Project Name: Additional work to be performed under this permit — check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ , i V V• v ti Windows/Doors Generator Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: 0 N -R/LESSEE: CONTRACTOR: Name v -/uJ Name> \ Z C— Address• `� b ow w Company: Address\\:\3-7 C& \-,\ : dR City:tN g v e R State: Zip Code: Fax: City:`h� b:5fi1 Stater, r� Phone No.. Zip Code: 6nM Fax: E-Mail: �@ f1 A+ Phone No. Fill in fee simple itle Holder on next page ( if different E-Mail i, Iha, benrdllloo,peihf, n N o State or County cense 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. SUPPLE ENTALING ONS ION LIE LAW INFORMAT10 DESIGNER Name: ENGINEER: vr, _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Addres o Address: City: Zip: Phone State. City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable 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 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 ;�Kg6ffaat71,—gA(@SOwner/ Lessee/Contractor as Agent fort Signature of Contractor/License Holder ( f STATE OF FLORIDA, ,Q� / ' �Cl.t� �2Ai =ate m STATE OF FLORIDA COUNTY OF /� �/I N . 2 COUNTY OF 2 5_¢ 5 The forgoing instrum t was acknowledged -before this day of A• 20 by Sw g m The forgoing instrument was acknowledged before me this _ day of 20_ by Name of person making statement. o_ «�;�;� Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification T Produced IV f.1 J� �S �/ W �C // Type of Identification Produced _ 1 (Signature of N ryublic-State of Flor da ) (Signature of Notary Public -State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED