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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: .\ ` �� Permit Number: 0 R AY ST. Lucle County, Per lttl _ Building Permit Applicatio S Planning and Development Services Building and Code Regulation Division 2306 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓ PERMIT TYPE: Vu�bJYS. �llhlbOV�! N.1D ��R RF.p1„AGE.l.IT' ZtJSTlL1..1. �.MP�GT DOORS PRORtOSED IMPROVEMENT MTI®N: Address: 0 N 39 ST. FMr PiucF. Property Tax ID#: Li`los- wi- ooZo- ow- v Lot No. Site Plan Name: Block No. ��AA Project Name: Mzs. 1`� me DETAllEO DEhSC•R(MM N R WORK: 6 w;1ZM+a lam' LftA 'rSTRUCTPGIN INF©RMATlO Additional work to be performed under this permit-check all that apply- / Mechanical _Gas Tank. Gas Piping _Shutters V Windows/Doors Electric _Plumbing —Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: O Cost of Construction: $7,10W . Utilities: —Sewer —Septic Building Height: OW .ETRACT®R: Name Rt &ACVM0L(%;C Mrtf, Name: T L Aa re N Co`mpanyJ"` "i State: 'r Address:` atAlN w T16 Zip Code':' A Fax: City;'Wl State: Phone No. o -.120101 zr`• ZipItode �g' /� . .. Fax: Q E-Mail: Phone No d5 -!'Ld� O Fill in fee simple Title Holder on next page( if different E-Mail % rri0. comcmt. ne from the Owner listed above) State or County License Z 508 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. SUPPLEMENTA ©NSTR CTION LI N LAW I FORMATION: 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 y BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNERS CONTRACTOR AFEIDVIT:;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.rujes, bylaws orand covenants'thatmay.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'anoilier 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." z Signature of,Own'e`r/'Lessee/Confractor.as Agent for Qwner Signature of Contractor/L'_ense Holder; ! - STATE OF FLORIDA STATE OF FLORI COLIN COUNTY OF &ok OF I The fng instr e t wacknowledgbefore me The forgoing inst ment wa knowledgecefore me this ay of 20 by this day of 20 ' by i OSc.R RAZ u n?'— Name of person making statement. Name of person mak��OR ent. , / Personally Known V OR Prod ucec�ldentification Personally Known Produced Identification Type of Identification Produced Type of Identification Produced (Signaturelo ota y'Public-State of Florida• (Signature Notary R.ublio-'Stat o o i a om fission No � '�+"� (SN�uYPubiicSteteolF -1 � Notary.PubUe State of F L. -. +P arybelf'Martirfez Marybell,Martinez �ir�- My'Commissfon GG 270975 Commission No. w, (�eaytromrnisswrtGG270 75 iia Eupires10i2412pyp ��► �! Expire 1,012M2022 REVIEWS FRONT: ZONING ' ' ~SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW- REVIEW REVIEW REVIEW REVIEW REVIEW DATE ; RECEIVED DATE COMPLETED Rev 2/7/19