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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COP`'_°_"TED FOR APPLICATION TO BE ACCEPTED Q ry Date: Permit Number: 5JJ V S r.iry tR�i��� © iti K , - Building Permit App2 9 2019 Planning and Development Services department Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial PERMIT TYPE: JLp� �� 0 _J rj- Z!. . "'b^R'Y �� Address: Property Tax ID #: Site Plan Name: Project Name: _ Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: 9 LlD S�, Sq. Ft. of First Floor: _ Cost of:Construction: $ Z Zorn. oo Utilities: _ Sewer _ Septic Lot No. Block No. Windows/Doors Roof Pitch Building Height: OWNER/LESSEE CONTRACTOR 3 xM Name o u c Name: �- s z2v/vg pp Address: P7/I— J 6 i4i /20Jx4 /�{ J /1 Company: City: P,.4 L LiC"r- State:r-L Zip Code: Y3 Fax: Phone No. 77.1 • o `t y d Address: City: Zip Code: Phone No State:_ Fax: E-Mail: Fill in fee simple Title Holder on next page ( if different from 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 $7,500 or more, a RECORDED Notice of Commencement is required. TION: DESIGNER/ENGINEER: _ Not Applicable Name: SEA 477/1cGFE�& Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: Address: City: City:_ Zip: Phone: Zip: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JO$ SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." � e r/ Lessee/Contractor as Agent Signature o/FRIDA cl �� Signature of Contractor/License Holder STATE OF - g STATE OF FLORIDA COUNTY ��� s z COUNTY OF The for oing instr ent was acknowledged befo /1 m tnN 11 The forgoing instrument was acknowledged before me thj%ya, day of Y J i , 20 by this _ day of 20_ by 0, a L e- .Se6-u-A/ Name of person making statement. Al �°y Name of person making statement. tr`tYo Personally Known OR Produced Identific Personally Known OR Produced Identification Type of Ide ific ' ri, Type of Identification Produced L , Produced (Signature of Notary P lic- State of Florida) (Signature of Notary Public- State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.