HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) 5 n
Date: 3 Permit Number: / 9 0�
RECE1
CE VE
Building Permit, Applica ion MAR 2019
Planning and Development Services
Building and 6de Regulation Division PEi�iYllttltlg (�epartlYlr
nit
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re 'de4tillu CoLantYr Ei-
PERMIT TYPE: '7—)
P OPQSEQ > ELOCAT.QN• /
Address: 9 717dil �1�-�� ". /• 3"�/Gp�/.5�
Property Tax ID#: 2 32 3 ` J—dl– OG�16 ` 4?0 - Lot No.
Site Plan Name: Block No.
Project Name:
DETAIL. E� DE-C ,I"T10 O WQ '
CQN5 ;� Q � O IV1A ION;
Additional work'to be performed under this permit:.-check all that apply: $I "
;Mechanical Gas Tank Gas Piping _Sh6)i"2rs LS(jj(``? _Windows/Doors
plr U 2 {Ji
Electrie��i} _Plumbing _'Sprinklers _Genoratar Roof* Pitch
Total;Sq. Ft-of Construction: Sq. Ft.of First Flogr: •. f
Cost of-Cons ruction }'� I'
t .$ � aG,Gs Utilities: Sewer,er`.<:•:Septic,: Building Height:
=-SSE ; CQNTRI�►C+TO'R,
Name ��. �i� It. Name:
Address: 664- Company:
City: �Ua,�'. Yi r'/l�� State:ISL Address:
Zip Code:j f/`f�{S Fax: City: State:
Phone No. /�/' �3_�f ��0 Zip Code: Fax:
E-Mail: �y R /gon` 6 l//yxi/. r&* 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.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
11 NO M-0,
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.
1 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."
Signature:of Owner/Lessee/Contrac or Owner Signature of Contractor/License Holder `
STATE OF FLORI s STATE OF FLORIDA .
COUNTY OF N COUNTY OF G✓
The f going instrument was acknowl me The for ing instrument was acknow ge efo
this day of 6�C—¢�, this day of 20 by
Name of/person making statement. Name of perso maki statement.
a
Personally Known OR Produc ,,,. ,. ion Personally Kno OR Produced Identifi do
Type of Identification a+�� ti Type of Ide c n
Produced .i6;��`�' Produced
(Signature of N Vry Public-State of Florid (Signature of Nota ublic-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
Rev. 2/7/19