HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �J Permit Number: 0 -3,U
RECO"'EIVED
■
Building Permit Appliation MAR 14 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 St. Luci .Ou my FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial '
ft
PERMITTYPE: no d W .
PROPOSED IMPROVEMENT;-LOCATION 7
- 1
Address:3��� S
Property Tax ID#:o< �n "1' .� Lot No.
Site Plan Name: Block No.
Project Name: (DR
-DETAILED-DESCRLPTION Q'F WO.RK___. . _3__ _ _ _ '• . . - --_ - -
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CONSTRUCTION INEORMQTION
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:
00
Cost of Construction:$ ��a Utilities: —Sewer _Septic Building Height:
01NNER/LESSEE - CONTRACTOR
..,�
Name Name: ► 1 t
Address: J S,� i a Qo Company: q�,e C,,/lT�a.�
City: _ State.�L Address: ��5 ��'S�
Zip Code: E!SL2 22 Fax: City: For K'e-cC., Stater
Phone No. "7v?g- -3L01- 969 Zip Code: 3d[ / '6-Q Fax:
E-Mail: `t xvM,---S a CSO Cp Phone No 772 9-31 yT
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License /A-t
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. O �`
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
DESIGNF-,R/ENGINEER: of 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."
ignaturiKof Owner/Lessee/Contractor as Agent for Owner ignatur of Contractor/License Holder
STATE OF FLORIDA< / Lt_,, CI STATE OF FLORt�►
COUNTY OF ` 1" COUNTY OF ��
The forg in instrument was^ac�owledged before me The f oing instr e t s a owledge efore me
this 17day of M & C��20�by this day of 20� by
Son
Name of p son maki g statement. Name f erson akingstatement.
Personally Known OR Produced Identification Personally Known �, / OR Produced Identification
Type of Identification Type of Identification
Produced Xklc�� Produced
1 btQc
41 16)
(Signature of Notary Public-Sta ublic- o 1 MCI
HASSNA SANABRIA 9?0 P`BG KATHERINE HAVENS
Commission No. ��b `� 5��90MMISSION#FF904036 QNISSION#GG165030
Commission N ��
EXPIRES:JUL 28,2019 EXPI ES:DEC 04,2021
Bonded through 1st Stale insurance Bonded through 1st S
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19