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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7 r ! Permit Numbi OR ED IAN 0 7 2019 Building Permit Applic aRrmitting Department Planning and Development Services Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CommercialResidential /\ PERMIT APPLICATION FOR: PROPQSE© LN OUEIUIEN LUCATI*"N: Address: F0 /leen 3 A/1-// -.i+ 91"eh f G. J 5 Legal Description: �eS ��4n� rl�• 39�7-�Z62 Property Tax ID#: L �OOI `5'01 — Q 2/d'— 000 -3 Lot No. �0 Site Plan Name: 416RCA Block No. Project Name: 90 Setbacks FrontBack: Right Side: Left Side:.!- DETAI ED DESC�R+IPTION NUF WORK: 60"a t/e a B<o ol n remav-4/ D Y00 W mai,'leo UNG /0r)G6u YOoin C6n cue CQNSTR�UCTi o INN! ON: Additional work to.be pertormed under this permit—check all that appy: Mechanical' _-Gas Tank _Gas Piping Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: S00 Cost of Construction:$ / ?,o9, Utilities: Sewer _Septic Building Height: f OWRjLE�SSE C©NTRA O"R: Name 1 Name: 67M 1 Address: '0 -Ale,hyn 8-ly Company:A141M jr;jti City: , t r1.fe'1 R"eA StateR.. Address: w/ ,/1:G. S10�rnGe� s{- Zip Code: 34/152 Fax: City: �renfB„ 'grazIA Stater Phone No. 30 - %_91 60 7 00 Zip Code: 30?5 Fax:772 WO-37K E-Mail: Phone No 772 ',Z32 ",2/4/ Fill in fee simple Title Holder on next page(if different E-Mail a0/4 PA Sr" C from the Owner listed above) State or County License 08642 61f 71 . If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LAW 1NIFORMATI�N: 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 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,'] 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 Commencementmust 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 rRrording yoig Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent f ' ' Signature of Contractor/License Holder ` STATE OF FLORID m{ STATE OF FLORID COUNTY OF s X" m COUNTY OF �co The for oing instrVm1aqt was acknowledged befor m z The fing instrur was acknowledged before this day of20�by thisday of 20�by 2 � pa 0 2 (Name of person acknowledging) (Name of person acknowledging) N m JAJ (Signature of ry Public-State of Florida) (Signature of N ary Public-State of Florida) Personally Known ,-' OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 4