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HomeMy WebLinkAboutBuilding Permit Application i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �Date: 6 -1.010) Permit Number:la5-0346, Recz ,;.-- 7. L, '...P-.: : - ' I fret) COUNTY • A f L O' R t b A Er �ry }�® 2019 - ._. - Building Permit Applicationpm-rrn Planning and Development Services Sr LU eDC u tment Building and Code Regulation Division Y ;1 2300 Virginia Avenue,Fort Pierce FL 34982 Y Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential !� PERMIT TYPE: • PROPOSED IMPROVEMENT LOCATION' Address: 3 Lf 2r 3t Af./ . , Property Tax ID#: 91 d Z V '" © d aLot No. / IQ 1 LI I" Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION.OF WORK 1. VP I LCe {'�(_5 4. 6 F, + 1/14-C v- pe cles4 5 Vlnr__- q,wl.pS.ct Pi r____- i CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical —Gas Tank _Gas Piping _Shutters _Windows/Doors tElectric _,Plumbing _Sprinklers _Generator —Roof. Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ '1)() Utilities: Sewer Septic Building Height: OWNER/LE SSE`E CONTRACTOR r Name J OC -4- U-r ,\ U v✓a-�/ Name: b 1 �V) L S � l , `ii Address: Z7 to a ch 9 U.VI' LE4 i VG C, Company: S4-E-.- I e G4-r l�C'_ s 1 r City: ,r''n. 'i ICC State:) I Addre\s�f'•- 3 ( Cala `a�e_ L,4-i-C__ vhf-y, Zip Code: ' '_` 0 Fax: City: Vel Cih State: �/I Phone No. -712- -^ 5.9 5 f q 3d.:7 Zip Code: :32-9 62 Q Fax:77 2 6ttq 5775 E-Mail: Phone o��77� - 5 7 Fill in fee simple Title Holder on next page(if different E-Mai . 1-e.J G v1 C y')/LQ. i , (Owl from the Owner listed above) State or County License C- ( >t 10 -3 9 r 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. I I SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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: II 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 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." AP n r Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5k- ' \ LUClx. COUNTY OF The for of instrume w acknowledged efore me The forgoing instrument was acknowledged before me this / y of 20 by this l.O day of ,20 / by 7 ai w$ Trk 01,e U5 S Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification F. Type of Identification �j Produced Produced ®L 1 l� L\-cut r h (Signature of Notary Public-State Florida) (Signature of Notary Public-State of r Commission No. AYdJ% ELLEN(15 1 GHN Commission No ?. yp'2,,, ELLEN Vft N 44400-;;;:state of Florida-Notary Public ,: State m sioida Notar Public ' Commission # GG 270079 � f_:,,41%�1*= ,Commofission #GG 270079 � �: : ' � •f A ,�F; vly Commission C+kplrea 0,l' October 22 n,Gxpirea i "itii"��. October 22 2022. REVIEWS .---s-'"---77-7-r.-',. . .. _, -• SOR PLANS VEG OVE COUNTER REVIEW -� REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ,I Rev.2/7/19 i I