HomeMy WebLinkAboutBuilding Permit Application Alt APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Permit Number:
RECEIVED
I'
- , MAR 112019
Building Permit Application
Planning and Development Services ST. Lucie County, Permittii
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce.FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential !/
PERMIT TYPE:
P OPOS D IMP �OVEMEN LO ATIQN
Address: Ri e-r L"
Property Tax ID#: c� � { CM2- 7O l00 -5r48006 Lot No.�_
Site Plan Name: Block No.
Project Name:
DETAILED DE�SCR�IPT ON O WO K:
evlc�� �)C ;+'MC. Door 96 K'7 - (J %'&
CONSTRUCTi. INEOR A ION:
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: $ /55'C�.Q e) Utilities: —Sewer Septic Building Height:
•' RT ISS-6-E : •ONTRACTOR:
Name /11;& ��8rr Name: ,2�iy-
Address: 7C. 7-- SF , C,0A 1-ti Company: A�
City: J95 L State:_ Address:
Zip Code: Fax: City: 6"C_ State:
Phone No. Zip Code: 3 tt�.- 5 Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License 2
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.
Sl11PPLE ENTAL CC3NERISMI N LI' N LAW N -@R AT aN:
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."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORID/►
COUNTY OF 5 Lpc COUNTY OF � • L\11c`';,,
The forgoing instrume¢t was acknowledged before me The forgoing instrument was acknowledg before me
this\ day of 11\k% 20� by this t\ day of W\6" .20� by
s5 .-, C, �s t, S5a,C. '�Ot\4
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 identjfirati
Produced L '� �-' Produced "r l���
(Signature of Notary P blic-Sta �, 1 pMpR1EG1� 023 (Signature of �blic-St®fA►�P�I 0023
�_ ,•"� MYM►SS►ON� rG6 2 20 MY COR S December 16,2020
Commission No. ;:• )D ahGoUnd°twnl°� Commission N =om ruNotarv ► �#�''m°m
Banda
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DATE
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DATE
COMPLETED