HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • 4T Permit Number: /�� )�,'�L
A
RECEIVED
1011 ft:�
ff
- MAR 2 5 2019
_ Building Permit Application
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax:'(772)462-1578 Commercial Residential
PERMIT TYPE: I
PRO` �SED IMPR{ E E LOCATItJN
.Address:
�] I Y1 t( CIIJJYct.e�q i(
Property Tax ID#: j � (a O;l I 70 -000 ` �jr Lot No.
Site Plan Name: Block No.
Project Name:
D PLED DESCRJlPTIC�N Ck QRK:
114" Y 000
CQN- ;�UCTIO;N II�FORMA IQN,
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
1
Total Sq. Ft of Construction: "a Sq. Ft. of First Floor:
Cost of Construction: $ ,00 y Utilities: —Sewer —Septic Building Height:
a ER/L�SS� : CONTRAC`�T
IN
01 WIN
Name / ,riS �PC�_�n W }—cx [ �� � � Name:
Address: I J-6 IA-6 lam. Company:
City: vo-vo C, State:F7L. Address:
Zip Code: 399(o,4 Fax: City: State:
Phone No. *309 - Zip Code: Fax:
E-Mail: h C Phone No
Fill in fee simple Title Ho der 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.
SUPPLEMENT CONSTRUCTION LIr N LAW INFC*}RMATION:
DESIGN ER/EN,GINEER: _ 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 TH B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUWtfi4PtR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatur f e/Contractor as Agent for Owner Signature of Contractor/License Holder. `
ST O FL RIDA STATE OF FLORIDA
OFUNTYj�' �, Lu(?-j COUNTY OF
The forgoing instrument was acknowledged before me,
The for oing instrument wa acknowledge before me this day of 20_ by
this day of 20by
P,Z S `l�y-rel ` Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification Type of Identification Produced
Type of Identification
Produced
(Signature of Notary Public-State of Florida )
(Signature of Notary u li -SS1a nr'rl Commission No. (Seal)
��aaYP�,, KAREN S. NIELSEN
Commission No. -� s State of F Fwtil�-Notary Public
=* °_ Commission #GG 207434
OF fI_V My Commission Expires
june 12, 2_22
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19