HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' �J Permit Number: 9
R NE C E I'Y' D
Building Permit Application FEB 112919
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie C9.unty, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT TYPE: r— �.
PROPOSED IMPROVE NT LOCATION ` `# }
Address: d 3 10W C1,coenJ6r- J0cr aI en LL
Property Tax ID#: yrf 2S' 7 01 - 8 "O Lot No.
Site Plan Name: Block No.
Project Name:
";.,,` v°' r a� t " s.r ,; ..
DET.`/#tLED DESCRIPTION$O ;WOR`IC y � r N 7k
Mr otIJ
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CONSTRUCTION('INFORMATION" r" k °" ` u ` ' '
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 8900 Utilities: —Sewer _Septic Building Height:
r
OWNER
/LESSEE ' 2 CONTRACTOR r
Name &Kv, CP tl w if Name: in i\', Za60f?Z
Addres ) n3 AW G 1-Peti br;"L✓ Company: (e iPhrP
City: 4-f Ct t State:FL Address:_
Zip Code:y y 2,9 Fax: City: PZI-t-–5�- State: FL
Phone No.(77ZO�,33 –J�d"� Zip Code:--�Z95- 3 Fax: —
E-Mail: Phone No 7'70) L4)
Fill in fee simple Title Holder on next page(if different E-Mail ' e ►'J4- v Q y0-4901 c o
from the Owner listed above) State or County License e 5YJS
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.
SUWPfIEMEN TAL3C0NSTRUCTION L N LAIN INFORMATI(JN `Ax
_ "•Jx,^``,. +,fir a '' a;�.t� _ ` ' iz roc -'> i,.,� `....rh.,'`� �. .'.
DESIGNERANGINEER: _ 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 or recording our Notice of Commencement.
Signat a of Owner Lessee/ContractorzsAgent for Owner Signatur of Contractor/License H
STATE OF FLORIDAc STATE OF FLORID
COUNTY OFA r �� COUNTY OF
The forgoing instru nt was acknowledged before me The forgoing instrument was acknowledged before me
thisday of 201 A by this__U day of 201,4 by
Y) I L0 ioQ_2E_ �n I 10 4 2&
Name of person making statement. Name of person making stalrement.
Personally Known �OR Produced Identification Personally Known --�_ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
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.