HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: al'a.�o` �� Permit Number: .
RECEIVED
_ Building Permit Applicatic n
Planning and Development services FEB 26 2-019
Building and Code Regulation Division
ST. Lucie Genf: errttltting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
P Q {aSED IMP O1/EMEN , LQCATItJN,
Address: °,` Q-_
Property Tax ID#: MoCL-Y-)7 z Lot No.
Site Plan Name: S �IV�I lV Block No.
Project Name: I I
t�ET ILED DL�SC� I�P?ION OF WO�R�K:
ZOO' ii i CU 00-In Yii
NNN�TRUCTIQN 1' FIRMA 1®N:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank , _GasPiping _Shutters,i _Windows/Doors
Electric _Plumbing SprigK6rs _Generator _�RogfEitgh
2�l
Total Sq. Ft of Construction:�w Sq. Ft. of First Floor:
1 c�
Cost of Construction:$ `0 Utilities: —Sewer _Septic Building Height:
OWIMUR,%90-5-0 CONTACT®R;
Name _ CL5Ctc\, Lqj-J'1 LO Name:
Address: blas _ .. . Company. -
City: *� State: Addre
Zip Code: `7` ILf City: 1 SL�O State:
Phone No. Zip Cocle.� `L G Fax:
E-Mail: Phone No Z ;6:� 0
Fill in fee simple Title Holder on next page(if different E-Mail i 0OLLO-\t-iy 1 C Q CC) ®G(Y\0-1 f
from the Owner listed above) State or County LicenseLQ� 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.
S PP'L�MENT `jL CONST +UCTt�N LI �N lAW l�N ��R�IVIATION:
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
f Ow r/Less a Contractor as Agent for Owner Sig ur ontractor/License Holder
STATE OF FLORIp STATE OF FLORDA
COUNTY OF COUNTY OF
The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me
thi�_day of r 20NI by this day of S4s-
20A 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 L >D L— Produced yr L L
(Signature of NotaryPublic-State of Florida) (Signature of -�
EN'lollS
........ D �1 EN.
Commission No. d�� p N#�G022023 °�' =.0 COMMISSION#GG0220o
0 020 Commission N ES:Deceml �t "
::?:.3ch•., M'(C0� mbar 16.2 efy °:+. P; Nota PublicUnder%wrile
�(PIRES:Dp blicUnderNnt : Bonded7tuu N
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REVIEWS FRO SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COLIN REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19