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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE �NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j Date: I , 6CANNED Permit Number: { • 03r)4 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMITTYPE: � ,' C— e, Address: Property Tax ID #: Site Plan Name: BY ucie County RECeWro Building Permit Application Nap unig aq ,*rq sr: „1d�� ent Commercial Residential Additiianal work to be performed under this permit -check all that apply: V chanical _Gas Tank _Gas Piping _Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Cost of Construction: $ ��� Sq. Ft. of First Floor: Lot No. Block No. Windows/Doors Roof Pitch Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: C©I�� AG -FOR: Name bvlc. Name: l�d Address: O= t7Erna Company:_tl'& r)C( City ti I: State: V Address i 21 e�iec�rr�2i 9P� Zip Code-Cl�''r { 'Fax 13 City �} IPiS C��I "I ?Y I�Stat PhoheNi=- ZO �l?(� —, n, Zip Code 4 Phone No E-Mail: l O Fill in fee simple Title Holder on next page ( if di rent E-Mail `)c,,Yne— State or County License from the Owner listed above) 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. S 14PPLEMENTAL C5N$7RUCeTIOXi E: W I FORMATt DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: State: Zip: Phone City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Name: _Not Applicable 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 /,HO—N THE JOB SITE BEFORE THE FIRST INSPECTION. I��OU INTEND TO OBTAIN FINANCING, CONSULT WITH/YOr1R LENDER OR AN ATTORNEY. BEFORE RECORDING Y NOTICE OF COMMENCEMENT." ier/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF I uo e The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _ day of 20 by this K, day oF36 \/ 2011 by Q I /� , c70, I ( 4'SAof f d _ A"1 �� VA�'- I troll Name o erson making statement. Name of person making statement. Personally Known _ Type of Identification Produced 'gna ure of Notary Commission No Ei! 31 ,? REVIEWS COMPLETED OR Produced Identification COUNTER 276NO 1.2022 Personally Known _ Type of Identification (Signature of Commission No. OR Produced Identification LASHAHNAINGRAM•RAHMING WCOMMISSIOK"275000 EXPIRES: December20, 2022 VISOR I PLANS I VEGETATION SEATURTLE MANGROVE REVIEWI REVIEW REVIEW REVIEW REVIEW REVIEW