HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:� Permit Number:
2� RECEIVED
Building Permit Applicatior MAY 01 2019
Planning and Development Services ST. Lucie Count,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:
PR01�5ED INPRDVEMENT"LOCATIO �° �S.
Address: L� 0 orad EL 3 qCy-
Property Tax ID#: a�d5''� �VS Lot No.
Site Plan Name: Block No.
Project Name:
a n�
DETAILED DESCRIPT_
ION aP WQRK g,
�. � C Y►'1 Cc Cfi W t n �SUS
C+DNSTRUCTIOC INI�ORMATI }N
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: Sq. Ft. of First Floor:
Cost of Construction: $(�IU DU 00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE g CONTRACTOR
Name cr al-ef ones Name:
Address:50 6 S IOGn RacLd Company:
City: I-erCQ State: rL Address:
Zip Code:Nq 7 Fax: City: State:
Phone No77 Z 4168-3C45-7 Zip Code: Fax:
E-Mail:A -0r%�do eS C-) C-)jylcl i I.&_�M 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.
SUPPLEMENTAL CQNSTRUCTIQN t.IEN LAUU tNF�JRMA
ION-
DESIGN ER ENG pp MORTGAGE COMPANY: N�
/ INEER: _Not Applicable of 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:arid 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.
Inconsideration of the granting of this requested permit, I do hereby agree that-1 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 recordin ur Notice of Commencement.
n-at6rey Owner/Lessee/Contrddor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 I� by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced L L Produced.
(Signature of Notary PubNA MARIE GIv[NS (Signature of Notary Public-State of Florida)
�xee•.
'= MY COMMISSION#GG 022023
Commission No.QG d-Q *= rj$f� ecem
Dber 16,2020
o, Commission No. (Seal)
�';e•••••o = BondedThruNotary Publicunderwrifers
REVIEWS FRONT. ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev. 9/26/18