HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //�
Date: 5 ,��L1 Permit Number: l ! 05---c �4..
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C i..�.N7 n : ''"hr. u RECEIVED
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.w :w Building Permit Application MAY 2 2 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
St, L�cie Comet my
2300 Virginia Avenue,Fort Pierce FL 34982 �//
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: r
Y-e 1'1 C C
PROPOSED IMPROVEMENT LOCATION. ° ' d
Address: 311 & S S . D-D-r d 5 � e� puLyuL �L 3 G1 3,2 2
Property Tax ID#: ?L/D- S' -(10.._
a -out-i) -OCU - --3 Lot No.
Site Plan Name: ' Block No.
Project Name:
DETAILED DESCRIPTION OF'WORK,
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CONSTRUCTION:INFORMATION
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _. Windows/Doors
_Electric —Plumbing _Sprinklers _Generator pRoo_f `-. Pitch
Total Sq. Ft of Construction: q f V, Sq. Ft. of First Floor:
Cost of Construction:$ l4 340 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR:OR
Name Mo r ce e et M k l-t dl e a_ Name:
Address:2'(/ t S - D--a- ;id ST Company:
City: i'I PLt ITA- State: F - Address:
Zip Code: o w 1 rZ Fax:,, City: State:
Phone No. -772- 3 /``�"// Zip Code: Fax: !1
E-Mail: Ira rceCama✓-/-rh.p2 35yfviad,Com, Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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.
1
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
:.. .. — Applicable , . �..
DESIGNER/ENGINEER: Not 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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 A ,TEORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
1
),L 491 �'" ,
Signature /
of Owner/Lessee/Contra,,or as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 3 -Luc(i COUNTY OF
The fofgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisay of rr Ay , 20 17 by this day of ,20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification1� n Type of Identification
Produced r L O( Produced
guctu,- ........„
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
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Commission No. l ,.II s ELLEN VITAHN Commission No. (Seal)
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41nu �b_State of Florida-Notary Public
• ., Commission #GG 270079
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1Ti.o , My Commission Expires
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a' � • ._ 2, 202
REVIEWS !► �.►.,!►:, ISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19