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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� j� (� Date: Permit Number: ( �D� o-Q 1 RECEIVED 1 .- e APR 3 0 2019 3 Ll1 JT Y F L 0 R 1 0 A Building Permit Application PerSt. Lumittingcie DepartmentCounty Planning and Development Services Building and Code Regulation Division oW 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSED IMPROVEMEI LOCATION ' °` Address: 1 O1 a . /1 ,OC2i-i..J G/uj L04- "-1 ' f Property Tax ID#: j) f " 00/(6 ©©0� Cf SO2 3 Lot No. t/ Site Plan Name: Block No. Project Name: .DETAILED 1)551RIpTI()N WORK? . eci /200 -fa 1-1 p ,661 vq(R) . 5 1 0. sA c� A/9 6,.) pa,- ./ Et' .:( I-16 5 fi--,./0 314 1 ,19( - CONSTRUCTION INFORMATIONo 4; Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric —Plumbing _Sprinklers _Generator <oof 3// Pitch — Total Sq. Ft of Construction: 7 Sq. Ft. of First Floor: 70 a Cost of Construction: $ OrA-C./,() tDc Utilities: _Sewer Septic Building Height: 1 OWNER/LESSEE. W. N CONTRACTOR? $' Name 5-1.),5 et.,-0 'TO 2Fein-0 Name: R(c 1 f9 4 2 -7—A.60t,,../z, Addresos�b 7.25 5 , 6 ree -fl r-�ei61� L-01.g9 Company: .Al1✓Q c l "/41€ /too f n� City: Ci n V !SR-✓ 6 Q4-c/LState F4,�Address: ?c c 2 67 C49-fel---0/1/---1—' 74c/ Zip Code: 354'q 5-7 Fax: 1V/Pr City: pJ c__ - State: ftp Phone No. cS (a29 Zip Code: J cit�7/��72 Fax: E-Mail: ,ity4:--- Phone No 0(r 7� L( F-2 / i Fill in fee simple Title Holder on next page(if different E-Mail /2(,O k i A c..) 1p. ,✓k. a q ch 4-( from the Owner listed above) State or County License _ at-r I 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. 1 1 • liPPLEMENTpd CONSTRUCTION UER a�'1n INFCIRMATIONo ... . 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 I will,in all respects, perform the work 1 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 • N ATTORNEY BEFORE RECORDING YOUR NOTI OF COMMENCEMENT." — / . ./(g.� . - ...---- Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contr.ctor/License Holder STATE OF FLORIDA STATE OF FLORID COUNTY COUNTY OF 4i"" l,Q OF S UI CA-------- The forgoing instrument was acknowledged before me The focoing instrument was acknowledged b fore me this - of /V , 20 �yby this .moi of jv , 20 20/l k Q/\C QA v 1� Name of person making statement. Name o person making statement. Personally Known OR Produ ed Id t ficJ ation Personally Known OR Produced Identification Type of Identification Produced �-�, �. Type of Identification Produced O C- ; (Signature of Notary Public-State of Florida ) ',►r�a_ZOZ ZZ J8go100 40'1'1-' • S (Signature bf NntAry� Pei , a WWI 0ri�j l _` Commissi., (Seal) I�oilgnd meloN-epliolA bo 81819 it"• ,, `�� " sa zsZ Commission goo. NHJf VA N3��3_ �, r s�o"dk� uo/S'�qe o'�9nd�Z DJ •#u wwo IV ,,u ., &u/ 1to-m yrj% REVIEWS FRONT ZONING SUPERVISOR PLANS` VEGE -,---,Iii"'i.SES .. t(O-7 : MANGROVE COUNTER REVIEW REVIEW_ REVIEW REVIEW ';-_ i'o`' ' REVIEW DATE ,' RECEIVED DATE COMPLETED Rev 2/7/19