HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a. a 5 1 Permit Number:
FI Lam . , RECEIVED
o
FEB 2 5 2019
Building Permit Applicatio
Planning and Development Services ST. Lucie Count Pertniainq
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PRO,P.O'SED-INPROVEIVIENT LOCATION:,,,,,,,, .
Address: �-
Property Tax ID#: �/ 9 — > `' " ��� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OFaV1/ORK:
o , Qw-
CONST RUCTION,INfORMATION:
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: $ he �� Utilities: _Sewer _Septic Building Height:
01N�NER/LESSEE "�CONTRACTOR:;, ,
NameName:
Address 'G _ 6 Zi— Company: `52
City: G State: j' Address: CNZr
Zip Code: Fax: City: State:
Phone No.' ` Zip Code: � Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page (if different E-Mail t rt
from the Owner listed above) State or Count icense J q 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.
S. 'LEMENTAL-CONSTRUCTION LIEN .LAW INFORMATION::.
DESIGNER/ENGINEER:� _Not Applicable MORTGAGE MPANY: _Not Applicable
r
Name: Name:
Address:_ Address:
City.-3;::v Stater City: State:
Zip: J,7�1 ZPhone7` � fr-2�_ I Cry � Zip: Phone:
FEE SIMPLE TI' HOLDER: _ Not Applicable BONDING COMPA _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 a 'ndicated.
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/Con Agent for Owner Signatu of Contract r/Licens o er
STATE OF FLORID STATE OF FLORI A
COUNTY OF COUNTY OF • L� ���
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledg d before me
this 2.5 day of 20)a by this a•. clay of 20by
Name of person makingl9tatement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio Type of Identification
Produced VV-l��1— Produced
DFANNAMARIE GNEN3
(Signature of Notary owig�GOy2p23 (Signature of Not c:, taf�Y&� ber16,2020
EXP
`' Nblio Underwriters
,••......S.. Y COMMISSION# 162020 "%�+r P onded Thru Notary
Commission No. PIKES U �unaerwdte" Commission No`
BondsdTrVU rY
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
kev. 9/26/18