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HomeMy WebLinkAboutBuilding Permit Application All APPLICAE LE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: s RECEIVED IP Building Permit Application MAY 14 2019 Planning and Development Services Building and Code Regulation.Division ST. Lucie Coun , Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: �� ut�6 1146EYL P OP©SED IMS' 01/�MENT LOCATION: -�y� �� Address: &2- G�'nlO- 1 F-G�-c Property Tax ID#: �C© -00- .7 (./X Lot No. L Site Plan Name: 109— U ti( -c Block No. Project Name: I D,S IN2 I I I @ I A DE-SCRIPTION OF NORK: CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors ectric _Plumbing Sprinklers _Generator _Roof Pitch. Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ I,Z-�iD ioo Utilities: —Sewer _Septic Building Height: OW N ESR/108SE E: CO NTRACTOR: Name Ooag r"1,1(� Name: �S'�6��-/ Address: 2 4'V� 1, ^lu �� Company: ��Cz = C City: State—", Address: Zip Code: `Fax: City: `"f State: Phone No. Zip Code: Fax: E-Mail: Phone No Z 5,3 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State o ounty License C 3(D 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. SU MINE:'M7, L CONSTR CTION LbEN LAW INFORMATION: 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 thepermit 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,-1 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU TEND TO OBTAIN FINANCING, CONSULT W11_H YOUR NDER OR AN ATTORNEY BEFORE RECO RDI UR N[OTICE OF COMMENCEMENT." Y,T' L/_� S�_, ctwl(� lvct Signa re o Owner/Lessee/Contractor as Agent for Owner SigaarefContractor/License Holder ST TE O FLORIDAA ST FLORIDA //��CO OF COOF • )0a, The i7ing instru ent was acknowledged before me The forg ing instru e t was acknowledge before me thisday of 20�by this day of 20J�f by Name of person making statement. Name of person making statement. / Personally Known OR Produced Identification Personally Known OR Produced Identification ✓ Type of Iden"tion',ation Type of Identificatio Produced Produced C_ 1 � AL (Signa ure of Not (Signature of Notary Publi , Ayp/�� KAREN S.. NIELSEN ���"Yp��l� KA EN S. NIELSEN Commission No. =iso UB _State of FIV Votary Public Commission No. ;'_°~� �B`�;Stat��o Rkorida-Notary Publ c mmissi r t GG 207484 _ *= Co ion #GG 20748 My Cornrnission Expires s My Commission Expires ',, 2'. hine2 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED­- DATE ECEIVED' -DATE COMPLETED Rev.