HomeMy WebLinkAboutBuilding Permit Application All APPLICP4BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: T
�.; ; `• ` f� _ "! RECEIVED
- Building Permit Applicat on APR 0 8 2019
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
PERMITTYPE:
' � flSED I 'F' 'Q'1lEMENT,�EOCATlO,
Address: �31I �j�ra� (�� Fa•^d' %'%�ce� FL 3 �1q.�2.
PropertyTaxlD#: ' -000/0 - Lot No.
Site Plan Name: Block No. �
Project Name:
dEa A LED DE�SCRC.PTI®N � ORK: -
tt o-A4,
�l i l
aCn� �gll�k'o^ D F "1,.IDOd ChtL pH AorI
V"11 A� O)'!e: �B.G`r� eo.s7'. 'J' V- G
C a STRU TI �. 'FOR A I*N•
Additional work to be performed under this permit-check all that apply:
_Mechanical _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:$ �00•a Utilities: —Sewer _Septic Building Height:
d � I�Rf LE SE CO�iT (3RR
Name 41b'r +0 Name:
Address: 571 1 r3. Pr Company:
City: PState: 0- Address: -.
Zip Code: 34q$1- Fax: City: " State:
-
-71
Phone No. �) U'�1�7- 7F.�� Zip•Co.de: _ Fax:
E-Mail: 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 CON5TFt CTlON LI�EIV LAW (NiFORMATI *N:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: 'K Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: k 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 YOJJR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Con ractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY1 - - COUNTY OF
OF W C l _
The forgoing instrument was acknowledged before me
The forgoing instr ment as acknowledge y efore me this day of 20_ by
this�day of 20 (( by
ETo Name of person making statement.
Name of person making statement!.
Personally Known OR Produced Identification
Personally Known OR Produced Identification Type of Identification Produced
Type of Identifi on
Produced (i
(Signature of Notary Public-State of Florida(UPAA _Ouc/
)
(Sigl nature of Notary P - Commission No. (Seal)
4'", KARE S. NIELSEN
=State of Florida-Notary Public
Commission No. *= COMA. # GG 207484
f FISP` My Commission Expires
rrnn"`� June 12, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA'TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19