HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: `/e-'�-7 Permit Number: �Q
RECEIVED
J APR 10 2019
--- - _ Building Permit Application ST. Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: Aate;
PROPOSED IMPROVEMENT LOCATION:
Address:301' /�e- ,� 4cG 3Y9
Property Tax ID#: WO�L-r,01- & -090 3 Lot No.
Site Plan Name: Aes Block No.
Project Name: v S
[DETAILED DESCRIPTION OF WORK:
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[CONSTRUCTION INFORMATION:
Adnal work to be performed under this permit-check all that apply:
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_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
r.�o
Cost of Construction:'$3y'00" Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name sic:-iq Name: 0
Address: 3a-6 2sS ComP anY: '
_ /
City: 0;4W4 Oz9�M State: let— Addresss:: C(
Zip Code: S"MY Fax: &Zlf- City: C411e-- State:
Phone No.Soy -906`oa Zip Code: 3,(?5-3 Fax: /t/r19
E-Mail: Phone No .1 - W
Fill in fee simple Title Holder on next page(if different E-Mail C 61+4 csk-r m oras',Ala
from the Owner listed above) State or County License CVC/T/YS 'o
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 INFORMATION:
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 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee Contractor as Agent for Owner Signature of Contractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA II
COUNTY OF Lijef I E COUNTY OF L I o—, ..
The forgoing instru4entwes acknowledgep�before me The forgoing instru ent W s acknowledge me
this 0( day of 20= by this day of 20 by
IS Let
Name of p6arson making statement. Name of plerson making statement. /
Personally Known OR Produced Identification V// Personally Known OR Produced Identification ✓
Type of Identifi ' n Type of Identific 'ars
Produced I Produced
i � Sr �
(Signature of Not lic-State of Flori a) (Signature of Notary Pu ic,,>r e,of Flp� � S. NIELSEN
° State of Florida-Notary Public
4'," EN CLSEN =� °; Comn�- Commission No. 56ao# GG 207484
Commission No. rlor, a, tary Public
�i,��o�� My C remission Expiros
ission # GG 207484 June 12 2022
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""` June_ 12, 2(122"'--
0 22
REVIEWS FROM OR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.217119