HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO 1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j l/
Date: Permit Numb
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Building Permit Applit
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APR 5 2019
Planning and Development Services mitting Department
Building and Code Regulation Division LUC12 County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: p \J J�
PRCIPOSE'D IMFRf3VE.'MENT(.00i4TION,
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Address: OW -T-),02 ,—L
Property Tax ID#: `�_�� O<- ��.� �d-000- 57 Lot No.
Site Plan Name: Block No.
Project Name:
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CONSTRUCTION INI=ORMATION
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Additional work to be performed under this permit-check allthat apply:
_Mechanical _Gas Tank _Gas Piping :i` Shutters _Windows/Doors
LYIElectric —Plumbing _Sprinkler's':.*_ Generator Roof Pitch
Total Sq. Ft of Construction: 1<260 Sq: Ft:i`'df First Floor:
Cost of Construction:$ i . 06 Utilities'' Sewer _Septic Building Height:
OWNER/LESSEE' g x XONTRA -.7 R
Name I �- _&fhe64d Name:
Address: /?fg]�: 4AI-2y" I/n Company:
City: -
state: V Address:
Zip Code: �S l ( Fax:771, City: State:
Phone No. `7�✓r� J G��/' aal7 Zip Code: Fax:
E-Mail:/l till `A 146'01-11* // V2tlOy- cex" 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW [NFORMATtQN
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Appiicable
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 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 YOURXENQER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sign atof essee/Contractor as Agent for r,.es Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF OUNTY OF
The forgoing instrument was acknowledged before m 9? he forgoing instrument was acknowledged before me
thi day of J JFACZ�— 20�;by his day of 20_ by
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Name of person making state t. ame of person making statement.
Personally Known OR Produced Identification rsonally Known OR Produced Identification
Type of Identifica ' Type of Identification
Produced L N% ►� •��C• C • Produced
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(Signature of Nota-0 Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19