HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q /� _ r1
Date: _� Permit Number:_ ` 6
4 =, RECEIVED
•
Building Permit Applic tion MAY 15 2019
Planning and Development Services ST. Lucie County, 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:
PROPOSEb"IMPROVEMt' T LotA-rit}N. " /
Address: l 02 77 I INV M art r�2 r ��, ._Jim Ci t V C7/
Property Tax ID#:_�f y �� 03- D p -D D •aj Lot No.
Site Plan Name: Block No.
Project Name:
te trifGr
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eONSTRucT Oi 'I oRn T,
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:$ - �a% 4 b Utilities: —Sewer _Septic Building Height:
CoNTRAcri
Name Awa re-t A%zgnlrrh Name: i G'Z-
Addres / 77/ ZIW -moi�► .� C4, Company: !-r
P Y�
City: State: , Address: /P:2 S L-g MJ
Zip Code: Fax: City: State:-,t-/-
Phone
taterPhone No. t7 7a) ,�.�(2_/ �� Zip Code: Fax:
E-Mail: Phone No 7 -gI96
Fill in fee simple Title Holder on next page(if different E-Mail o ,0 , 0
from the Owner listed alcove) State or County License 12 ri Y-3
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.
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SUPPiLEMENTAL: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 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,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."
Signat re of Owner/Lessee/Contractor as Agent for Owner Signature-"of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 1C'.,1✓ COUNTYOF
The for Ing instrument was acknowledgedbefore me The for ping instrument was acknowledged before me
this xday of AIM .20—q by this�day of 2045by
�1te.7� .� 11 U 4ft LA Dc-Z,
Name of person mhking statement. Name of person mak ng statement. /
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Ident;#Gatfo fipi
Type of Identien
Produced Produced
JL
(Signature of Notary Public- -X�ture of Notary Pub Ic-State of Florida)
KAREN S. NIELSEN
Commission No. .`o�� -{�,�.,u Lid S. NIELS
ocl�' �l of Florida-Notary Pgh' fission No. o`raYP�s�,, ,
=* *_ Commission # GG 2074634 _ �,SCa"fe Florida-Notary 'u lic
lyly Commission Ex fres =*
*= Commission # GG 20 4
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Une^.�. - Junc;.12, 2022
REVIEWS FRONT S VEGETATION -�
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DATE
RECEIVED
DATE
COMPLETED
Kev.2/7/19