HomeMy WebLinkAboutBuilding Permit Application All APPLICA LE ITFOnnMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 -1 . Permit Number:
RECEIVED
MAR 01 '2019
Building Permit Applicati ff. Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 .Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: I j
vv. 6
PROIOSED I PROWEM �NT LOC TION:
Address: 3 8 c rv.+a. ; n s RCk".'s- L g L{
Property Tax ID#: (�1 - c/oU"D Lot No.
Site Plan Name: l Cir Coy ��c.� . Block No._
Project Name:
INAILED DE-ASCRIPTION OF W®RK: �
n�Re kA^noc W C t o u-�.A�1 \ut c.� c - Cls-
CSN^TR+U N-N I 'FORMA 9QN:
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: $ Utilities: —Sewer _Septic Building Height:
OW ER/LE-�SSEE. CQ N TRAC OR:
Name 62Ler VlC Name:
Address: Company:
City: State:P Address:
Zip Code:1 cC1_ Fax: City: State:
Phone No. �2- 5�3 C) - )e Io Zip Code: Fax:
t
E-Mail: l -0,'A Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
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.
SUPPI.EM@ TAI.C® STINN LI N LAW INFORMATION:
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
COMMENCEMENT.,ATTORNEY BEFORE RECORDING- YOUR NOTICE OF.
f/L
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledgegbefore me The forgoing instrument was acknowledged before me
this 3 day of M d d •20` by this day of 20_ by
C,b `:s \rp f war k vf\A Y�
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
(Signature of Notary P lic-State of F �eGINE�s (Signature of Notary Public-State of Florida)
,�^� p yNK #GG 022023
Commission No.� 'd..) MYCOM� mbe 6,2 0 20�ess Commission No. (Seal)
c 1
NN�CPIRE_ otaH�bfieUndetwn
REVIEWS FR ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED