HomeMy WebLinkAboutApplication for Zoning Compliance - Use Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED \d
Date: Permit Number: 1 ) a 1 a3
V#
RECEIVED
-Building Permit ApplicatiO JAN 0 8 2019
Planning and Development Services..
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential' r
PERMIT TYPE:-
PROPUSEDrr! OVEMENT LC?CATIQN
Address: f Ola l l2 La,! cO S
Property Tax ID#: Ci C)a did – S Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WO K:
3C,2een a-N V T-2-L- ro.Jr Via:�
CO STRUCTION 1fORMAT!'ON:
Additional work to be performed under this permit—check all that apply:
_Mechanical —Gas Tank _Gas Piping _Shutters _Windows/Doors
_
ElectricPlumbing _.Sprinklers _Generator _Roof ',' Pitch
Total Sq. Ft of Construction: ^1 2 Sq. Ft. of First Floor:
Cost of Construction:$ 3s" b Utilities: —Sewer _Septic Building Height:
91W."NE07HUSS OEWNS TRACTQR:
Name A L dC256 Name: C
Address:39 CAGB e Z.e g Company: arx
City:- :.1� G .,_.__. ....._... State:F Address:o7 9
Zip.Code:=3C{G.S� Fax .r:. City:. r ' I'e State:
No. 50,1 Q'a"� �0 3q .3 Zip'Code I Fax: 7�2— L/�o)�d'��`�
E-Mail: Phone No T Z
Fill in fee simple Title Holder on next page(if different E-Mail f\a4ejPI Sh Z 35 k @ �rodl - co r'l
from the Owner listed above) State or County License 3 d b Cp 3
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.
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: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to clothe work a.nd 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 our Notice of Commencement.
Signat re-of Owner/Lessee/Con ctor as Agent for Owner Signature of ontractor/License Holde -
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAS LJ c COUNTY OF
The forgoing instrument was acknowledge efore me The fo going instrument was acknowledge before me
this \% day of 734v 20 acknowledged-before
this day of fid+Y\ 20by
Name of person making statement. . Name of person ma kini statement.
Personally Known OR Produced Identification. Personally Known OR Produced Identification
Type of Identificatio Type of Identification
Produced_ N- Produced
(Signature of NotaryP lic-State of Florida (Signature of NoVPub3l,.i,,c-SiateCommission No. MAENSDEANNAMARIEGIVENSC� pGe X20 yCommission No. a CaMMISSI( 4022023
• �(pS: °K' Un _ •rEXPIRES December16,202D
*: .<r public = Bonded 7Fw Notary Public Underwriters
REVIEWS FRONT SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER .REVIEW REVIEW REVIEW REVIEW . REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev