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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPI.Y. FOR APPLICATION TO BE ACCEPTED ( (P Permit Number:li� SGAry NED BY St. Lucie ',aunty RECEIVED Building Permit Application ppR 09 101 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 - Commercial ittin9 DePartmenl Pecst Lucie County Residen tai PERMITTYPE: F'R© O5ED f FEiC?1 E a7�OGRT,I.Q � ` fi *W1 ,. , '1 Address: ' ( Onnf'J c) AO w13T' j D 6-e PropertyTaxlD#: a,I? `,crciLot 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 endows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _,6-v` ��ti ich Total Sq. Ft ofr[r, Sq. Ft. of First Floor: Coq o i pan5t"" u o � 10 - 0 0 o Utilities: —Sewer _Septic Building Height: 101,:' Af �R#'k�t�,�»sQG�ESSEpRIP.. N, 7RAG�T�fJR1 fTmeSs, V% g Name: dress: 600 '1 Cb v o: a61 rRCk Company: "City: �'t. 1?-C-e e State: IF1 Zip Code: 2� V clLt S Fax: Phone No.-7"71-MLa5—Lkv3 -173 35q - -Address: City: Zip Code: -Phone:No State:_ -Fax: -Mail: Lg3i .. ill in fee simple Title Holder on next page ( if different ,Born the Owner listed above) E-Mail 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. Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: Address: City: City:_ Zip: Phone: Zip:_ 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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." - ignature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF LUCI P COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of A" 20_q by this _ day of . 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificationr�,, X>L' Type of Identification Produced�/I /�w Produced (Signature of Notary Public- State of Florida) (Signature of Notary Public -State of Florida ) Commission No. �7 � x VA' =� raW4miss n No. (Seal) =o; ye -Notary Public -y - -�• N GG 270078 REVI :.;. �4 • bllc t1PE 2022. - VEGETATION SEATURTLE MANGROVE ��L,�EN =SftFlond (1atfThiSWon @�GVd 70 REVIEW REVIEW REVIEW REVIEW REVIEW DATE ' October 2, 2922 RECEI DATE COMPLETED ev.