HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO 1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: h• i• 1 Permit Number: '
RECEIVED
Building Permit Applicatio MAR 272019
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:
PRtPC'3SE
Address:
Property Tax ID#: Lot No. 1412
Site Plan Name---75' 9 Block No. a_
Project Name':
Cis ci.g£� � ;ek �� F � ��s�?W-st '-,DCiJ&.
co� �-���CT � ( �oRn� � • n�:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
1
_Electric _Plumbing _Sprinklers _Generator _Roof k_ Pitch
Total Sq. Ft of Construction: 6d�K Sq. Ft. of First Floor:
Cost of Construction: $ 9ro - Utilities: —Sewer _Septic Building Height:
O �Rf LE�-4SEE< C�3NT R;
1
Name C��L C�n�ou�S Name: Q
'Address: v 14/&V41, c J Company:R ice• IAM4C.t4 r�erhC
City :'! d) Stater AddrCnss D� � 1¢" amA Z
rT ti /+,r� �`4:�ej±, ',:.:';•s,.r�:q '� .ttC1.'i tl°!i.1i'?';i'•. .,. s
Faz.� City: Stater
Phone No r ', Zip Code
E-IVlail _ <r Phone No
Fill in fee simple Title Holnom_-:.:�-•�dei onn'ext page(if different E-Mail x/11 .�
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$7500 or more,a RECORDED Notice of Commencement is required.
5 'PPL.EMENTAL CQNS7 'UCTION I.iEN LAW 1'N�F®RMAT(• N
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
POSTE N THE JOP S TE BEF E THE FIRST INSPECTION. IF YOU TO OBTAI=INNC,,CONSULT
YO LE ORNEY BEFORE RECORDING YO OTI OF C
igna a of Owner e e Con as Agent for Owner ignature. ontract License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY COUNTY OF 1J
OF � �.r� sv
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me this day of 20_ by.
this day ofa20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identifications Type of Identification Produced
Type of Identification
Produced
Is
ignature of Notary Publi -State of Florida
(Si nat re of Notary Public-Sta of Florida ) Commission No. (Seal)
Commission No. .$I s NAINRAHMING '='�' G .ItAHMING
MY COMMISSION#GG 275060 t`•1 ;sem ;YQ�'�' I gSION#GG 27506
:Qe '�. nCc
WNTi�R�—
L.R: a: 1RES�QO 84111fU Notary I?u UrAw*Uem :�. ; fJ� VREVIEWS OR PLANS VEGETATIO b T �,bTcl N
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19