Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: ^ Permit Number: C RECETVEb • - � - i�in. >.�_ MAY 2 9 2019 Building Permit Application 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: ®, rYGGj�70� PNPOSED IMPROU MENT tOCATI©N: Address: ��7Z S �4G17 � �� .d•�i `OT 3� ���/s P tel_ Property Tax ID#: ©o Lot No. Site Plan Name: Block No. Project Name: h0r5ol/ Res/,OG'yice— DETAILED DE--SCRiPTION • WORK: nF1?7aZ/.f11 ote-�/J ?11116' ;W/Z02 1.SC2zz-A/ CO BINUCTIO FORMA )ON: M1 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: EGD Sq. Ft. of First Floor: Cost of Construction:$ a000 '710 00 Utilities: —Sewer _Septic Building Height: OWNfR/LE-SSSEE: CONTRALTO : Name Name: Address: /G72.!� S -� ;. �, �f�Z Company: City: -: Pivf�iy ✓ 1 '=: State:,�q, Address: Zip'Code: _ yS�7 Fax:'3?J r -'s City: .��/mss �%T� i' State: Phone No. � �. 9 7 =' Zip::Code �3��i/� Fax: E-Ma y ' Phone No Fill in fee simple Title Holder on next page ( if different E-Mail /Z"--Gf 4�' zz;�" 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. SUPPLEMENTAL 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." SignatLyKe 6KOWKerl Lessee/Contractor as Agent for Owner Sign at tractor/Licen a Holder STATE OF FL RIDA STATE OF FLORIDA OFUNTY / COUNTY OF LF. /(•uc ir The forP�ing instrume t was acknowledged before me The fo oing instru e t was acknowledged before me this a�"7 da f 20�/by thi day of / 20/1 by , 1w, A Yd- /Z , '/ / e Name of person making statement. Name of person making statement. / Personally Kriown OR Prod u dentification t/ Personally Known OR Produced Identification Type of Identification Produced 7)1 Type of IdentifjeaCion Produced i (Signature of Notary Public-State of Florida ) (Signature o otary Public-State of Florida Commission No. Seal) '�\,,,,,,, KARE S. IELSEN ;��""YP�a�; KAREN Commission No. ,�:�Y°�8�,, ;, �sState of F S' N�ELSE to of Flb?41 Notary Public +� co iorida-Notar N °+ •= Commission #GG 207484 `: mmission y public 4,,or n�.� M #G G 2 My commission Expires n,,,,��� Y Commis 07484 June une 72, Z 22 fres REVIEWS F S R PLANS VEGETATION SEAT VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19