HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: { Permit Number: 1 (Sri 13
RECEIVED
APR 0 12019
Building Permit Application
Planning and Development Services ST. Lucie County, Pormitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PRC?Pt.§�MP IMPROVEMENT Lt?CAT ON:
Address: l�°��' 2��✓l/ /
Property Tax ID#: �+�a4' 60a - a�a5 -oa.o --5 Lot No.
Site Plan Name: Block No.
Project Name: Ol(
DETAILED DE=-SGRIFTION O ORK:
rJ( l127X IuIctIALVIII
Ps
CONSTRUCTION INFORMAT119N:
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:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
7OW R/LE�SSEE CONTRA OR:
Name 7 L 7,V! Name:
Address: 56 "A-1 AL-& Company:
City: _F6 �IQ State:�_ Address:
Zip Code: S%K7 Fax: City: State:
Phone No I3 ;-171—11 V 01 Zip Code: ` Fax:
E-Mail: 7v c7wa.,I, 01Y7 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.
�UPPLEMENTA CC}NSTIRUWCT1C'N LI�� LA 1 I,N 'ORMATIC .
11
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 YOUR LENDER O N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Le&e /Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY COUNTY OF
OF 5*k , A--0 c�C
The forgoing instrument was acknowledged before me
The fogoing instrument was acknowledgebefore me this day of 20_ by
this day of Ok by
-M ej V f 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 L L
(Signature of Notary Public-State of Florida)
(Signature of Nota ubli - Commission No. (Seal)
,,,rp�,,• DEANNAMARIE rr,022
Commission No. _ MY COM SEW GG 02200
_*
EXRIRE SEW 1B 2020
'%lBOPF o= BondedThru
Notary Pub"a Under4WID
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19 .