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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE AFCEPTED Date: Vv 01/—(9 SCANNED StPermit Numbed t V (/ BY . Lucie County oo_, PFC" Building Permit Applicatic4l, r Planning and Development Services Building and Code Regulation Division a Pd 2300 Virginia Avenue, Fort Pierce FL.34982 � a��3P'^ Phone: (772) 4614553 Fax: (772) 462-1578 Commercial "� Residential PERMIT TYPE: Address: n PropertyTaxlD#:-,3h7Z fZL�©D�,0019—' Site Plan Name: Lot No. Project Name: t7o l/amp ,,o L Block No. Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ n ers _Generator _Roof Pitch Total Sq. Ft of Construction: .-% D 1.51 Sq. Ft. of First Floor: _ Cost of Construction: $ Utilities: Zip Code: Phone No Fill in fee simple Title Holder on next page ( if different from the Owner listed above) _ Sewer _ Septic Building Height: City: A010019 State: ZIP Code: ,32go 7 Fax: Phone No Sri E-Mail J7 eftdV& rf State or County License._,d S o 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. No( QAbagea ►zI �-:4 LAs►5 5) si A,' SUPPLEMENTAL CONSTRUCTIONIIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State`. _ City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phorie: 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 the Florida plans, 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 I - ROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON E. JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH OUR NDER 0 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ignat a of 0 essee/C ractor as Agent for Owner Si ature of Contractor/License Holder STATE OF FEORMA AdMI ". ^` STATE OF FLORIDA COUNTY OFFZ��c�y�t✓1 COUNTY OF 0j,,,, (Oa•,tt The forgoing instrR'Men was acknowledged before me The forgoing instrument was acknowledged before me day of ��-,A,.'_,eA , 20� by this �� day of J 2Vv1F:Qf 20 by this // / ��t Name of person making statement: Name of person making statement. Personally Known -,X— OR Produced Identification _ Personally Known % OR Produced Identification Type of Identification Type of Identification 'Produced Produced Mc) '`'�ykY .A (Signature of Notary Public- State of r�-., ti "� (Signature of otary Public- State of F)md"a) ^DANIELLE JEAN H NNDN MBA •• Commission No. = (.yealy0 R Y :Commission No. `�. Notary Public -St to 1 Florida 1 �j �� w -) Commission # F. 95383 '7 D ' ; (g ,penF op c� My Comm. Expires 23,202 REVIEWS FRONT COUNTER - ZONIttJt�y •. REVIEW�L1 p G .• Q ELLY'.• S�1ft�rJS,`OfY Vp ��• PLANS VIEW - VEGETATION REVIEW _. SEA TURTLE REVIEW tary MANGROVE a REVIEW Ass DATE RECEIVED •, DATE COMPLETED ev.