HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�
RECEIVED
WA
3. APR 3 0 2019
" Building Permit Applicatl ftT. Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V
PERMIT TYPE:
PROPOSED INPRC}1lEMENTLflCAION,::'
Address: 7 E 1 114-t�-�} S % � a jg,S aZ
Property Tax ID#:--Sq 15 /5- 0 / 14. 6001 Lot No.
Site Plan Name: Block No.
Project Name:
DET�1lLED'�DESC, lPTI4�N OF�aWORK a � � a m
CONSTRUCTION INFORMATION
-aE<s..a.
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
�y. r
Total Sq. Ft of Construction: / Sq. Ft. of First Floor:
Cost of Construction:$ U Utilities: —Sewer _Septic Building Height:
01NNERjSSEE
Name [C 1 d: ', Name:
Address: 7 tea— g • Company:
City: Gg7� LuC4 e— State: l'L, 'Address:
Zip Code: 3!d--Ci, Fax: City: State:
Phone No. Z�� 4 a7 3 ���j� 'Zip Code: Fax:
E-Mail: QC L qui j /2 RR� 1940—//e !9 i41 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.
-77777,7,
St1PPLEMENTAL CONSTRUCTION LIEN LAW tNFQRIV{ATtQN
,
m ;
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.
1 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/ContractorQ Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I . t L30,��, COUNTY OF
The Wing instr ent was acknowledge pefore me The forgoing instrument was acknowledged before me
this day of 20 by this day of 20_ by
Name of person making statement. / Name of person making statement.
Personally Known OR Produced Identification P' Personally Known "OR Produced Identification
Type of Identificat' Type of Identification
Produced Produced
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(Signature of Notary ublic-Sta ture of Notary Public-State of Florida)
"o".""Y KAREN S. NIEL EN
to
Commission No. � ��� of Florida-Notary Fflt4n� fission No. .(Seal)
Commission # GG 2C7484
�NOF P� MY Corn missi on,Ex iros -
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9
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW _ REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 9/26/18