HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' �� 1 Permit Number: I 1 O � 07
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Building Permit Applic tion MED
AR 1 9 2019
Planning and Development Services
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Building and Code Regulation Division Permitting De
2300 Virginia Avenue,Fort Pierce FL 34982 St, 1e l e rtm e n t
Phone: (772)462-1553 Fax: (772)462-1578 Commercial untyr PL
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: pp {{^^.
Address:- 00202) �e,n-ML
n ii Cl- b ✓C:C . r�-. Pr�rfz 3 LOi 5
Property Tax ID#: 20 (
Lot No. O
Site Plan Name: Block No. 7
Project Name:
DETAILED DESCRIPTION OF WORK:
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FCO114STRUCTION INFORMATION:
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: n Sq. Ft. of First Floor:
Cost of Construction:$ L9 0 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name - R1 C-4-40L rd Lt)k,209,✓i Name:
Address: D 1 , 4-tc m,We— L1. f rl Company:- R& 6 " d06,r^ �c�f LLC
City: 9U1CA 1h S0VN IsIra,yi State: L Address: [c, d
Zip Code: 3Lf'f C/9 Fax: City: Aaar--f—5-t- L u r ,Q State:�L
i PhoneNo. ?, d- f�! Zip Code:_3Fax:
E-Mail: Phone No 772 '�a 7 373�
Fill in fee simple Title Holder on next'page(if different E-Mail "Co "
from the Owner listed above) State or County License .3x3 '2
If value of construction is$2500 or more,a RECORDED Notice of Commencementis:required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required."
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;..
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLD . _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 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 YOU W-ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT,"
Signature of Owner/L see/Contractor as Age or Ow Signature of Contra r/License Holder
STATE OF FLORID - STATE OF FLORI o
12
COUNTY OF COUNTY OF N
The forgoing instrument was acknowledged be f r> The forgoing instrument was ack owledged bef _
this day of C.G�'1`,20 by this day of j'>x�12� , 20 by 0°
X11 0 Gi )b�elr� � 5 .
n
Name of person making statement. Name of person making statement.
Personally Karo OR Produced Identific �bOt= Personal) n OR Produced Identifi "o=_
Type of Identificati n �,�// Type of dentifica 'on ge
Produced Produced � •,�+``•�
(Signature of Not#fPublic-State of Florida) (Signature f otary Public-State of Florid
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7 1