HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: 3 I Permit Number:
RECeTVE®
Building Permit Application MAR 0 8 -Ji5
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
PERMIT TYPE: ESQ` k•` r
PROPOSED UNP' ®UE=,MEN LQCA IDN:
Address: 7-00 F/ tM.rw
Property Tax ID#: . q5It-flo -06 0.f—//o —Y _Lot No. _
Site Plan Name: Block No.
Project Name: UAt ! it p �4
DETAILED DES. R PTiON O WORK:
CONSTRUCTION KN!I&,' ATION:
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:
01NNERII/CE&SE 0 TRAa6 .0
Name Name: Fr'.11 �/. "r rn-ft,tti'
Address: `Z n(� w �sytics✓� %" Company
Citi: State:EL AdWr'essSS:' o. � CoE,�v,Ksf
Zip Code: :�.-q.q 1 Fax, +�� <City:-'��I zlt i' '"^ State:rf--
Phone No. 73Z 213 (, L(A 3 ~Zip Code 3LIc(5' Fax:
E-Mail: Phone No q5q 605 1063-7 -I5N5-zo z2A
Fill in fee simple Title Holder on next page(if different E-Mail Ird' AGI b,fr e r 0 i'cla r�
from the Owner listed above) State or County License a9 12/0
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.
SUPP IUI A ST'+ C'1"IDN E LAW F ANTEX
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 or recording our Notice of Commencement.
J I-
01_ ,J; ' - /L
Signature of Owner/Lessee/Contractor as Agent.for Owner Signatu a of Contractor/License Holder
STATE OF'FLORIDA STATE OF FLORIDA
COUNTY OF �"414 J o c i u COUNTY OF 57.,1ty i«
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of %!ii r,, h 20% by this day of �?/1t�vv+'l 201 2_ by
Name of person making statement. Name of person making statement.
Personally Known�OR Produced Identification Personally Known r OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-St to (Si ature of Notary W iYf _&JAMMba)
^t WniniZsw.#GG 090721 oma�is:
ir-
Commission No. '°�»,°` ( xp1 Iry uF0ikSlPd'hdB90 CJ� ISSIOn NO. F •E�`L` 0 Seal)-' 3857U1
t.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.9/215/18