HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED dd
Date: o Permit Number: `��3"��D�
RECEIVED
RM
• MAR 12 2019
Building Permit Applicati n
ST. Lucie Counter; PisP°Cetiglll9
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: �� \
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ENfLU AT1i I• .:.... ..r ---
Address:_(90d"7 tl ._ f
Property Tax ID#:� HO 2"U tO "'D o `Cl Lot No.
Site Plan Name: >Q V 8"( UT S Block No. 491
Project Name: `>nva
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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
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Total Sq.Ft.of Construction: � �0 Sq.Ft.of First Floor:
- Cost of Construction:$ Utilities: Sewer Septic Building Height: _
Ww"Al ON '701
Name ► pc Name: 7 C
Address:C112_ filcL4Cal- fS tis %b.r.. Company:_ e-c)NA LV OF S �LaYt
City:tarmq ws State:LG Address: 5_ 3f 1-3a 1,.4 ,4u-2
Zip Code: ,W31 Fax: City: ( L.f1,�v c State: L
Phone No, 2 Le D ` d 2-24.2- Zip Code:53332`T Fax: 75'Y-02?
E-Mail: IM t aL i e, R I) 4 01• (!J)d Phone No 71E y',227-8'5S)
Fill in fee simple Title Holder on next page(if different E-Mail rg7,F—(/'-(1Cff `°' 69-0)L - e&-,I"
from the Owner listed above) State or County License tnr /32,Y66J
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.
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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.
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 thepermit 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 NO OF COMMENCEMENT."
Signature of O ner/Lessee/Contractor as gent for Owner Signature of Contractor/License Holder
STATE OF COUNTY OFORIDA�/r 1 M COUNTY OF STATE OF ORI®
Theing instrgntt wwa knowledge before me The forgoing instrument was acknowledged before me
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this day of t-l�� ,20 by this�day of 20 by
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U h �i I h 1( � Vl
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rry n making statement. �— Name of person maki��ed
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Known v OR Produced Identification Personally Known Identification
ntification Type of Identification
Produced
.WA.WAI
of Notary Public-St q�f Qr[iia)MY COMMISSION#GG 00{ a re of Notary ublic-State F Nctery PubriC State o P daEXPIRES:July 6,2 20 y Danialla P Castro
rF. o�Sry gC, 1 ra •?� �AyCommisiionGG 6n No. o n„ Bel ed Thru Nota Public Un edlEvgrtl iOn NO. alF•xpirait 1011612021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED _
DATE
COMPLETED
ev.2/7/19