HomeMy WebLinkAboutBuildling Permit Application r.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '�/,,
Date: 3- 1 Sri°� Permit Number: [Cr C 3 0 o
( T
F L 0 R o Q _ RECEIVED
___ le Building Permit Application
Y f
Planning and Development Services MAR 1.51018
Building and Code Regulation Division �erniletln�Depa�
2300 Virginia Avenue,Fort Pierce FL 34982 5t. Lucie c un y
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentia9
PERMIT TYPE: '
PROPOSED IMPROVE LOCATIO
Address:) 9 /1(6 C 'del t do 1"n IGI r (Sf , 3W g 3
Property Tax ID#: 3 41 9 6(p.5- DO Q()I I Lot No. 9
Site Plan Name: Block No. II
Project Name: �ryrva4� C� . . . _; __
®fir l„. DE--SCRIPTION I WORK°
/3ott f'd 011 blot() r 2`P , two gg i-c°S .: ale- U t wz/1( 904 I3
,On e Jo 1 d ri1v ,90-le- r 6' -ell
CONSTRUCTICI INFORMATIONo
f
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: 2y Sq. Ft. of First Floor:
Cost of Construction:$ 1300 Utilities: _Sewer _Septic Building Height: B'N-
OWNER/LESS-SEE? 4 CONTRACTOR°
Name '00-kiln C , - -ewaTr1-
Name:
Address: 2-0( A fJ • 0 PICA L 1 Corppany_
City: ftb') , cin 4 - La(.cC State: Address: . ,_.._
Zip Code: 3103 Fax: (17f/4 City State: i�
Phone No. y� �`�/ :� f� � �� Zip Code: ' ' , .. - _F _ ...
1 E-Mail: N(� 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.
NN PPLEM IL' CONSTRUCTION [LO[ ''it,l DNFORMATIONg
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 YOU• NDE• I R A •TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatur owner essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STA E •F FLORIDA STATE OF FLORIDA
COUNTYCOUNTY OF
OF aiLtLe;C
The forgoing instrument was acknowledged before me
The fo going instru nt was acknowledgec),before me this day of , 20_ by
this � � day of Jnni- , 20 Pi by
�-7 _ !v. . _ t/,�
�.. d • ; Name of person making statement.
woo .erson making statibment. V
Personally Known OR Produced Identification
Personally Known OR Produced Identification Type of Identification Produced
Type of Identification
Pro sced
(Signature of Notary Public-State of Florida )
:n.:ture of Notary ° blic-State of.F ri..1Commission No. (Seal)
. ;vv , LAS INGRAM-RAHMING
Commission No. : MY=
WAN GG275060
•
z"a•.rte`.b�: IXPIRES:Decembei 20 2022
'•'Fp. oe`'�
Bonded Ma tints •Puhfir Ur dP/writers
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19