HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: , o i j Permit Number: ..
s RECEIVED
s
Building Permit Applicati n MAY 0 3 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _K
PERMIT TYPE: 0\�0 060 g-
PROPOSED IMPROVEMENT.LOCAT N
Address: (P 6 t CopowkVL
Property Tax I D#: I -�o ll &1 f b 3 1(g - 00 0-- Lot No.
Site Plan Name: L A k_r_-i 00j> 'PANk(- Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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:
Costof Constructiarr _. 1i Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Td,), Tr Z 'Ti41dt ova- Name: -P44i- A Qr' p'l sjtJ
Address: jg(oa (—C' &iu�'yt, Ayt Company:
City: E'mr- State: F( Address---6606 1�jQu I'A1& AW
Zip Code: 34?S'I Fax: City: '
12t- Pceo-t-_ Stater
Phone No. Zip.Code` 2401SI Fax:
E-Mail: Phone.No �`74-&;L1 — L4( t I
Fill in fee simple Title Holder on next page(if different E-Mail�,M0 i La i/A/&4 SCJ:✓ (� &Akt J . Ca At
from the Owner listed above) State or County License G f&C-14-S?7(9
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 TITLEHOLDER: _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
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 COMMENPAMENT MUST BE RECOROE137AND'
POSTED;`ON THE JOB SITE.BEFORE THE FIRST INSPECTION. IF YOU TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING UR NOTICE40F COMMENCEMENT."
ignature of Owner essee Contracto as Agent for Owner Sig ture of ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ,Si loom, COUNTY OF SE tvwt
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgeq me
this—Ldayof 20[F by this--[—day of /I i 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 Produced
a 0 C 0 J
(Sig ture of Notary Public- lori i (Signa re of Nota Public St da •
,� Nniel 0 Connell. " baniel O'Con 1
?os-3d - a
Commission = ��� # 21 Commission No.0f =* atSi # ��
EXPIRES:May 10,2022 EXPIRES:May 10,
''� •• .� �'.• a
AnwricnIMa
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW. REVIEW`
DATE
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DATE
COMPLETED
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