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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1 Date: T' S� �T_ Permit Number: yy REC Fit;a &.011VC PR 5 2019 Building Permit Ap IicatioA Planning and Development Services Department Building and Code Regulation Division Permitting p i FL 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County Phone: (772)462-1553 Fax: (772)462-1578 Commercial en la PERMITTYPE: l? 7W Address: // Q S t";R A � .� Property Tax ID#: 940, 1 - 25 ool Dba-7- 6l,®— em Lot No. Site Plan Name: Block No. Project Name: DET/�lLED pE �RlPI'!QN tJ1=51(Ut3RK, x i SLR-c1L X i S Ti�tl 3 'T'P-Y( CQNSTRUC-Fl INFQRMATION g , Additional work to be performed under this permit-check all that apply: XMechanical _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:$ � vv Utilities: —Sewer —Septic Building Height: C?WNERjLESS w., 6 f CQNTR/ CTR. r: Name. . ' .,. J©. 10-Ne- Cf�-tWAIA Name: Iq: LFA U0 . Address: 5 T. Company: P I AAL A _FA A-40 City: Fog-r PIS 4Ge State:_E& Address: L AA;`E� Zip Code: 2? Fax: City:P0'V7-J'7 ' L_to Lr./'6- State: F-L, Phone No. a` 3 ! "J7 7 Zip Code: �3�/g63 Fax: E-Mail: _RTGCf2/uDh .Q�QS`brlfi�t,,t;�f Phone No '77P� - 3S ?-- 03Z-6� Fill in fee simple Title Holder on next page(if different E-Mail /�L� �L7U�v /� S('G�fl'i•/� from the Owner listed above) State or County License �a 14Z 2 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. Sl1PPi.EMENTAL C0�ISTRUGT(ON l� N LAW DESIGNER ENGINEER: _NotA. ,a_ �,�.�_ .. .•_,._ �, .;_ .� . .... ..,. .0 . ..�.__=. �Y ,> ; .....,.,. ;;_ / pplicable 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as AEro Signature of Contractor/License Holder +>s'';6. STATE OF FLORIDA �-�Q� STATE OF FLORIDAa, " .COUNTY OFSl�ICOUNTY OFThe for ping instr ent was acknowledge The f r ping instr ent was acknowledged before 0 this dayof 201 this day of� 20 .by S*ca� 1�1 Co W Name of person making statement. V Name of person making stateme oc Personally Known OR Produced Identi `i ,� Personally K n OR Produced Identifica Type of Idgintif4tion Type of Identific io Produced ILWd2 -4 Produced 14,X ~ �J ( ignature o otary Public-State of F rida) (Signature of N ary Public-State of Florida ) LJ 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 ev.