HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4. Permit Number -060
:
—(Rod
RECEIVED
APR 2 4 2019
Building Permit Application
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
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: ._ l o equ-o Pt rQs c-r -Cloyk- Pier L
Property Tax ID#: 1.312 '941 U UI COO ' f5 Lot No. 52 C�
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
V1,
) Y`e-
FC0NSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _ Gas Piping T Shutters Windows/Doors
�.Electric _Plumbing —Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:3 -S*S nth(su Sq. Ft.of First Floor: /
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name . Name- watt'-"-.ya;>6 1!&
Address: Company:U ,�crr, 016, r an( — C._.._
City: / State: Address• S
Zip Code: Fax: City: State:
State:
Phone Noo f�; � C��/ Zip Code:3J 911 c Fax7b,961 ^S1(.0�
E-Mail: T Phone No- )a- Lb l S
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 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 HOLffpR:-,, Not Applicable BONDING COMPANY: Not Applicable
"'tt. ov", RRI
Name: &vd 4-\_� A. , AW Name:
Addres h Address:
City:
C'e- F/ :3 Lj- 9"7 City:
Zip: �ii 1 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 r.epresentation 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."
-t
Signature�IfWwner/Lessee/contractor as Agent for Owner Signatgr�of o'ntrnctor(license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ' LLuf — COUNTY OF
411.
The f going instr t was acknowledgeA before me The for ing instrj�,ent was acknowledge�before me
J
th! day Of 20tl by thi!Mday of 20 P by
gni el j\J ot's
Name of person making statement. Name of person making statement.
V/
Personally Known OR Produced Identification— Personally Known_OR Produced Identification
Type of Identifigati Type of Identificatiop—
Produced Produced i- L_
A A
{Signature of ubli_ Signature of Notary Pub-Tic-State o F
KAREN S. NIELSEN
REN S. NIELSEN
,�'�o'ppV 4'ef;��StaiWiflocida-Notary Publi, Rim P Public
Commission No. C' ion # GG 20748 ission No. �_Szaw of Fjorida(se1107484
_s 4
my Con, Commission# G6
Commission Expires commission Expires
10
June 12, 2022 Mv -
june 14,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEG6W-iW7-Is LE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
--b-A—TE
RECEIVED
DATE
COMPLETED
Rev.