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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: 4- t c - i9 Permit Number: G Ct Oj,� I OL1 r; iliMISMINNIMMEMOINIMIIMMI CID Li IN1-17 3e Reci, F L 17 R I A '_ I vet) !I -um —Immilmommosar, Building Permit Application AP R162019 Planning and Development Services P ermitti 2300Build1ng and Code Regulation Virginia Avenue, Fort Pierce FL 34982 ivision St, LIZ Co,)Efner?t Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential )C PERMIT TYPE: PR®P®SED IMPR®VEM !'L®CATI®Noy Address: S L400 ,t.l, 1 12-k-- l O. u- 1 Property Tax ID#: 3 2- 8 " v02.�- 00,3 j - C) � P Y © - 3 Lot No. J Site Plan Name: Block No. Project Name: ___ ___ 1CNTtfggD]DES@VFRITII;O;N[O;dZcaR§K: ► �,0,/J ac 1/4.)'TIT- C s-) )-z:s .�.�- �,&-- C®NSTRUCTI®N ONF®RMATI®Na ° .A°7. . `, ' 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: co 1 Sq. Ft. of First Floor: Cost of Construction:$ I - 3 2 0 ' GO Utilities: _Sewer Septic Building Height: I OWNER/LESki • CCONTRACT®R° Name C ts.(Z°A..5 ,P•fLt-t r-Da.-T?yiJ Name:- .LS,�(i! N ni1 , p Address:8 4.9-0 }-2_�.,S L4> L Companjr: o GCS+-) �- Tre,L 1Lt, , 1..)� City: pe, .ST i -(c--1. E State: `1/4- Address: 3lQ D Sc..-3 " ----R-Ark- Zip er Zip Code: ,3,(R g ce Fax: City: ,3,--k_c 0._Ar✓t17Y1._- State:lrr _ Phone No. Zip Code: ,,33v __ Fax:9. : I0L f: g(P 69 E-Mail: Phone No 9Si-('-4.-2) 8__ R l (e ; Fill in fee simple Title Holder on next page( if different E-Mailt: 2)SiA,•S t-E.A tJE,X-1.� &-t. C vt& from the Owner listed above) State or County Licens�N' L is-2_.q 2'1 \ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1 If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.. I 1 SIP11110MENTIAL eCINISTTIRIVCTIIC©LIIMI LLAWIINFdRMATIION: 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 represu sentation that is granting a permit will authorize the permit holder to build thesubject 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 COMME _ MENT MAY RESULT IN YOUR PAYING TWICE Fs'• •ROVEMENTS.TO YOUR PROPERTY. A NOTICE OF • . L��Ljj EMENT MUST BE RECORDED AND POST ,t t E JOB SITE BEFORE THE FIRST INSPECTION. IF Y. �� ND TO OBTAIN F CING, CONSULT WIT` I LEND • OR AN ATTORNEY BEFORE RECORDING YOU• ' ICE 0 -O EMENT." )(nature of Owner/Lessee/Contractor as Agent for Owner Sign, re of Contractor/License Holder STATE OF FLORIDA STATE/ OF FLORIDA COUNTY COUNTY OF LS-)r UCCU . OF u+ L(A C!`C The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this/6,day of .42(,/2 , 20 19 by this I(play of ,x/2/1 , 206 by • e((1 InQl/ \lam' ' Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced ft— ti✓ Type of Identification Produced P./-• (�L ///oLt}r- (Signature of Notary Public-State of Florida ) (Signature of Notary Publi .te of Florida) Commission No. i I (Seal) Commission Np • YPvei�' ELLEN VAUGHN ELLEN VAUGF-IN 11� U i ;a° ilii <o:State of Florida-Notary Public _`a° i j State of Florida-Notar • . ' • •��• ommission # GG 2 0079 ; F� My Commission E(Ores {�� REVIEWS 1 'iT TOCANINE 20:2SUPE VISOR PLANS VES ETATION S ,Wir20'2MAN.ROVE LU UN it ntvinv • ` EW REVIEW v - EW DATE RECEIVED DATE COMPLETED Rev 2/7/19