HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,._ - t 5- k 9 Permit Number: lie(OS-19A qe-i
COUNTY- '-'111 RECEIVED
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‘1111111111111110111111111ii11111111111W Building Permit Application MAY 13 2019
Planning and Development Services
Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: - •
Address: 5l9-. (2. ---1-17.1 1c C/67. 1
Property Tax ID#: i 41 0 - 501 - 014. - 000 - 5 , ,L --7
Lot No. I -r ' /
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK
reP 10 c-c v--14. 54-c eA O ('+ m.r-tc r p-e_c,1--c 5-1-a I
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical Gas Tank Gas Piping Shutters Windows/Doors
____
_ —
K.Electric _Plumbing _Sprinklers Generator Roof Pitch
—
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ /01 0 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:' ' " CONTRACTOR:
,
Name I Veil 6 (4..d. Li .; Oh I Name: WA.- LS
Address:_.67.9 J-yi i-co
f t -y Company. -a s4--- (pc,
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,
City: r_t_ . )-21'e IC-C State: 0 Add res : A ( ' 'it—- VI)
Zip Code:541 Fax: City: 6 4.4: t C- State:
Phone No. 773 --7,6 g- •-7 5-0 5 Zip Code:32A(g i Fax:172_2( 1'- q-176"
E-Mail: I PhoneNt 77-I_- 5- q - q / ?
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Fill in fee simple Title Holder on next page(if different E-Mail 5t, fl ej-ir I C e_.---__q 016 ( I , (mvi
from the Owner listed above) State or County License ig CO duo 2-2.3 9
If value 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: • Name: i
Address: Address:
City: State: City: State: I
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 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'Isuch
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the grantingof 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 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."
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA � ww nn STATE OF FLORID& L
COUNTY OF ' L.UC LL COUNTY OF lit
The forgoin instrume w acknowledged efore me The forgoing instrument was acknowledged before me
this / ( y of 20 L- by this (t) day of /4 ,20 iqby
1 -u36 -VA(0 I7ec-01S
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification �j Type of Identification
Produced ! 1 v Produced
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(Signature of Notary Public-State Florida) (Signature of Notary Public-State of of r
Commission No. Witt?, ELLEN(18A 1 GHN Commission No "YP",,I� ELLEN VIMAIN
_State of Florida-Notary Public - 2sstate of Florida-Notary Public
Commission # GG 270079 =_*P—�o*` Commission # GG 270079
1._ 9, m _..— .October 2.2 r vty rniy
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. .t� ; ,��� Comslori E,plros
October 22 2022..
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DATE
RECEIVED I,
DATE
COMPLETED
ev.2/7/19