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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONV- All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� Date: SCANNED Permit Number: POD.- iDOCC by �Si. Lucie County i1 RECEIVED Building Permit Application FF_B 0 12019 Planning and Development Services pe�ittn9 DeparMent Building and Code Regulation Division •, Luc1e County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: Address: GlO Property Tax ID #: -?,40Z _ (a O Z '— Ev`o� Lot No. 3S Site Plan Name: µ��Q ���L�� G'��� Block No. \ 3 Project Name: N.�7�L+.LS -� kkD Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ ShuttersWindows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator V Roof Pitch Total Sq. Ft of Construction: 'Ll % b�0 Sq. Ft. of First Floor: Cost of Construction: $ rb 060 Utilities: _Sewer _L,�Ptic Building Height: ?�O W%LE5&EE.'s�*p1URA c IOR +,o $ i.no :1i .asp 4d Name �-ci� l� Name: Address: C_rC • Company " Address: City:_ State: _ Zip Code: :F24c't6Z Fax: Phone No. City: Zip Code: CtQ Phone No '::Z"7— T Stater_ Fax: q E-Mail: Fill in fee simple-ritle Holder on next page ( if different from the Owner listed above) E-Mail 15;1 0 LA bA Etye�l� B4d 1t� 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. 5 UWKNac©lr@ gmall.cc s Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Zip: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: 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 rnmmpnrinp wnrk or rpeordine vnur Notice of Commencement. Signature of er/ Less Er ntractor as ent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF .�1- LAO_a� COUNTY OF S4 .1\k Jt' ♦ R- The fo going instrument was acknowledged before me The forgoing instrument was acknowledged before me this aay�off I Z11Qo 20j� by this �day N-Q� 201 by �W � A � /off 1 �W lAPv Name of person mhking statement. Name of person makihi statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced slbea�'`t�l1�lJha� Produced (�J�y-'�'yDY�r.9�>GYD �-�Y�4hP (Signature of Notary Public- State of Florida) Q Signature of Notary Public- Late of Florida ) Commission No. RptIMING mmission No. �.PMWNG �yyp i........, •t Irv•`-- #G'GV ZIP avy :. •; . p.F/00MMISSIONBGG2T5060 REVIEWS FRONT PLANS VEGETATIO .',' ro. I:xPIRE� T COLINTE REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.9/2b/18