HomeMy WebLinkAboutBuilding Permit Application All APPLIC LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: +0 Permit Number:
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� REO�-tVED _.
- - Building Permit Application APR 0 9 2019
Planning and Development services ST..Lucie County, rmitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: i1 a I 0` l�f_c''S 1zG('/.0 . CAB &? 204 3
Property Tax ID#: d �y J '7 ��� TUU C� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK;
I `�' e£ SSI►' �uh SRM �. - /N Ale- P%) 14CAr
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_V echanical _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:$ �I�GYJ� Utilities: _Sewer _Septic Building Height:
:.OWNER/LESSEE: CONTRACTOR:
Name SC Name: 'RlC19AI G/IP-7
Address: Akf7(ZS 'L�Wa Company: 2EMCALe fNC
City: �r!/y.5�1J l�c.1[- Stater Address: G A) Lei Zunl
Zip Code: 3 �l,'�� Fax: City:�,l/L1" Sf LLYrct- State: r1'
Phone No. 44111 a la Zip Code: `-f 019,3 Fax: X
E-Mail: Phone No :57Q, F21 C6 Q.17 S 1
Fill in fee simple Title Holder on next page(if different E-Mail 1 k VoCl-'-n t2z- Z 13 C
from the Owner listed above) State or Coun�x License - o
ev 449IC91
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 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 1 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
VRTjH YOUR LENDER,OR AN ATTORNEY BEFORE RECO RDIN O NOTICE OF COMMENCEMENT."
ZIZV If?] POO 041%
Sign a of Owner/Lessee/Contractor as Agent for Owner Signa of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF 1C;I COUNTY OF
The fpToing instr ent was acknowledged before me The f7.0ing instru ent w s acknowledge before me
this day of 20� by thisday of ' 2011 by
Name of person making statement. / Name of person making statement. /
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identi eation Type of Identific ' n
Produced Produced
(Signatur to S to of F orida (Signature of Notary Public-State of Florida)
im
�"YPV�,,, KAREN S. NIEL Ef� ,o��YP�,,, KAREN S. );,SEN
Commiss Q State of -i a-Notaieau.c Commission N ���= Commission # GG207464 _* *_ f flbrida Public
: - a` Commission #GG 207464
=,, «V My Commission Expires
un '���„�`���� June 12, 202
REVIEWS PERVISOR PLANS VE OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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