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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa. All APPLICABLE INFO MUST BE C6MOLETED FOR APPLICATION TO BE ACCEPT'.. ' Date: Z' 3'I / Permit Number:©�� 1 oUANNEU BY �fe>F St. Lucie Count/ 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 APPLICATION FOR: Address: Building Permit Application Commercial X e Residential Property Tax ID#:_I-%SOa.%U.;—) Lot No. Site Plan Name: _ IYI,� - M A 2 Tr— Block No. Project Name: Setbacks Front Back: Right Side: Left Side: _Mechanical _Gas Tank _Gas Piping _Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction:$ Utilities: _Sewer _Septic N vindows/Doors _ Roof Building Height: 7 ®WNER LE-SSEE: C®NT P.CTOR: Name-X�Af LA6sOAl Name:� 2S9 e'e Address: 0 e� D �'`lwos Company%_/tas�WCIeZ✓erx-jk �A) . City: ' ` ! ''" l`'Statei'rA Address: 41 010• City: u<% v ==•State lih Zip Code ' N Pax'" /�5< P Zip Code: Phone No 3i�/r% p Fax:+%7Z 3`' 1•g�/ E-Mail: r Fill in fee simple Title Holder on next page (if different E-Mail z-E& A % OP 047OZ- as State or County License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIE LAW I '- O@ M9 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 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of CommencenWrit\ AA Sign re of Owner/ L(Oee/Contractor as Agent for Owner Si ture of Contractor/License Holder STATE OF FLORID`A� / STATE OF FLORIDA COUNTY OF COUNTY OF The fo oing mstr was ac owledged efore me this day of 2020 by 0 of Florida ) Known OR Produced Identification Type of Identification Produced Commission N (Seal) COMPLETED The for oing instr�m eppt was ac owledged before me this i day of _FZ1 _ e V 20 / by Notary Public- State of Florida Known OR Produced Identification Type of Identification Produced Commission No�(Q1, \ "j (Seal) SUPERVISOR I PLP REVIEW REVI Use MANGROVE REVIEW