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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 9 Permit Number: r 117)� I .L; e ��' y'! RECEIVED Building Permit Applicatio.11 JAN 2 8 2019 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT TYPE:. PROPOSED INPRUVEMUS LOCATIO Address: ,op) C,lc3 (`�' L� �2 IFY4 Property Tax ID#: (_(� ��(� (� T(Ono �t Lot No. W I Site Plan Name: Block No. Project Project Name: ©ETAIIEa aESC PTION OF WORK: W 4--c-ez .r HCl 5 L L abQ Qom- vgo s�(c/h' C .n CONSTR�ICTIO NEORM ID Additional work to be performed under this permit—check all that apply: _Mechanical —Gas Tank, _Gas,Piping —Shutters . _Windows/Doors _Electric _P � Plumbing _Sprinklers _Generator ' oof r A Z-kch' L q1r Total Sq. Ft of Construction: y� Sq. Ft. of First Floor: yI on 00 Cost of Construction:$ 20 Utilities: —Sewer _Septic Building Height: OWNER/LEM-5101 C© TRACTOR: Name Name: �- -� 1 Address: �l Cd�� L l�5 /Z Company;';` :. s- City: l(��2�.Q State: Address S Zip Code .. Fax: 'i` City: `�`j1— _ �; State:` :/ — `�5 — Zip Code:.,.::- r, Phone No.. ,,:� .�, �(s,��•. `? �— :-1 � -�� •Fax �, E-Mail: Phone No �2 ��Ci LL Z Fill in fee simple Title Holder on next page(if different E-Mail &K (✓ /�CU OLGI' 1� from the Owner listed above) 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. DESIGNER/ENGINEER: Not Applicable P 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,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>:b'e recorded and posted on the jobsite before the fi% rst inspection.,If you intend to obtain financing, consult with lender or an attorney before ; commencing work or recording our Notice of Commencement. Signature of Owner/JLessee/Contractor as Agent for Owner Signature of Contractor/Lic nse Holder STATE OF FLORIDA STATE OF FLORIDA tt COUNTY OF COUNTY OF The for ing instru ent was acknowledge before me The for oing instrun ent as acknowledge before me this day.of 20 by this day of 20L by C P,1 Qlad _P. cku k Name of personmaking statement. Name of person making statement. / Personally Known OR Produced Identification V Personally Known OR Produced Identification t' Type of Identificftt= Type of Identificati L / Produced Produced -741 4k (Signature'of Notary Pu - R S: RIIELSEN (Signature bf'N "%%YP��I� '. " State of,Florida-Motary Public I """�� KAREN S. N'IELSEN Commission No. •_ Com of,,, # GG 207484 Commission No =State of Florida- g��)Public My om, fission Expires ;� o`, fission# G 2U7484 June 12, 2022 ', My Conmissiom Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW. REVIEW REVIEW DATE RECEIVED DATE COMPLETED !;Fe—v.9/26/18