HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFY MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date;
Permit Number:
�zf RECEIVED
MAR 18 2019
_ _..... .. ...... .. . Building Permit Applica Q11
r:I.;t-1�(a C�sif5tyr, PQrr�'ilcelrtg
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:
mi
PRQPOSEDNPRC}Vt*NiENTA�OCAT10lg �F7.
Address:
Property Tax ID#: �'-1�''L�uO�����C�Z Lot No.
Project Name:
W, ,�, sit "a '., _
DETAILEDI7SCRPTION.UF 111IQRIC "
a a s a x ya Q � C c a A
CON`
VIP �t7N 1KORMATION K}s e
Utilities: _Sewer _Septic Sq.Ft.of First Floor:
Cost of Construction:$ Total Sq. Ft of Construction:
eFLOUOPIAii DEIIEIOPME1CtT PERMIT for.structures exrnpt fraln'13' 'Id* are Irl the
4I6atlplaln
=Nonresidential Farm Bwtding Temp.1 .1iBldg/Shed,usedxc[usively for construction
1VIobile�Madularfrterrcor�5truct� n afficeNBldg:Involved 1n dlstflb oelectrclty e
Other . Floaone` BFE Floodway Y/N If Y,
No Rlse Certificate wlthNupparting ata attached?SY/N ,�
�x
All other"applicable state and:£federal,perrrits`shil she csbta3nd`prlr�r'tr Commencement of �Y
'OWNER/LESSEE �_ �s `' � CONT�tACTt7R �' `s� 3 4
Nam Name ayn "-
Address: - �LG.tl11L- Compan \ALX -��LSLU-
City: -(-� �' ��— State:_ Add-:4T s:�)9� r - SSA
Zip Code• �S Fax: City JA CVZ- Stater
Phone NoC� N ts,. . • V,5)(D Zip Code: Fax: _
E-Mail: Phone No _-a -73?CS
Fill in-feesimple Title Holder on next page(if different E-MailX (ig w+
from the Owner listed above) State unty Li ense E�2_q
If value of constructiomis,$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.
bey
SUPPLEMENTAL CQNS_TRU CI-IQNILIEN lAW INaRfVIATIQ.I •
DESIGNER/ENGINEER: _Not Applicable MORTGAGE CO Not Applicable
Name: Name:
Address:
City: State: -City: State:.
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _N pplicable 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 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 jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencin . k-or-reEoLding your Notice of Commencement._. _.------ ---� =-----
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOFS-�r• \--6C\';,' COUNTY OF Sk, l-Jc'%Q
Theforoing instrument was acknowledge before me The foggoing instrumen was acknowledged before me
this day of d+ 20� by thday ofd d` 20Na by
va. .\ '�O, "ra5 17Su6r' 'tom \ X'Na3
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 Identification .
Produced. Produced
GIVENS
IE 23
(Signature of Notary tate of FI �r* SS10 16 2020 (Signature of Nota pRIEGNENS
, tr1Y S:D�embe demtiters :: ::�,
=_: «= SPIRE taN pubfwUr =:° s .� .�AY comfAiSSION#GG 022023
Commission No. rded �1' Commission No. XpIRES: r16,2020
"'T •o?; ded Thru Notary public Underwriters ,y
"''FO .`.•` Bon
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
- DATE
RECEIVED
DATE
.COMPLETED
ev.1/9/2019
IL