HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I ZQ� ( l Permit Number:
RECEIVED
- Building Permit Application JAN 2 9 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
PERMITTYPE: W pia � S
'PROPOSED INPROVEMENT LOCATION.-, .
Address:, 6�Z � o V.>�c, I or� P {lKQ 31gjZ
Property Tax ID#: L\ ��" 5 - d d _a Lot No.�
Site Plan Name: 1 Block No.
Project Name: r r� �ti2 woncUw> �Nu !`S
DETAILED DESCRIPTION OF.WORK
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c. .' 61 OA .S V�J W n V..��-�1 (r '
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(� S S 1-6 1-T kM CLlw �k 00 DrAAC I�
CQNSTRUCTIQN IN':FORMATION:
Additional work to be performed under this permit-check all that appZh
y
_Mechanical _Gas Tank _Gas Piping utters /\Arindows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
cam.
Cost of Construction:$ ?,aC'o' - - Utilities: —Sewer _Septic Building Height:
OWNAC
ER LESSE
/. CONTRTOR
Name Name: Pr"G &'VAc4
Address: 6RL Reo U4r� �c��✓e' Company: Is(-t.Ae- LA-'1\
City: NzrQ I e rc -e State: Address: (DZ S W S�"r v'
Zip Code: 3(tct 9 Z Fax: City: 1'C9r'[ M.L-'.c*:v State:FC
Phone No. -712- Z(6-IZ3?6 Zip Code:-K4 U�( Fax: T12—.� 7�- 9 776
E-Mail: Phone No '?-12''-Z I -19 1`
Fill in fee simple Title Holder on next page(if different E-Mail c s hVrJ. CV
from the Owner listed above) State or County LicenseeRCl 33 C)G 1
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.
SUPPL`EMEN�1/ L CONSTRUCTfON LIEN LAIN INFORMATION,'
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t
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, 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 orpecorAng yoANotice of Commencement.
Signature of O n;rA
see/Contractor A nt for Owner Signature of ontr or/License older
STATE OF FLO STATE OFFORIDA
COUNTY OF LJc-�'Z COUNTY O
The forgoing instrument was acknowledg%before me The forgoing instrument was acknowledged before me
this a� day ofyaty\ 20 by this day of;75d Y--,- 2A by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced L ID L
(Signature of Notary Public-State of Florida) (Signature of Notary Publi
Commission No d IEGl sp23 +"f==; � DF S1014# 22023
DEEM IDN#GG 022 Commission
s MISSION#� �o
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REVIEWS FRO �" SUPERVISOR PLANS V TION SEA TURTLE MANGROVE
COUN.- REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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