HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
40
Building Permit Applicatio
MAY 3 0 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:
PROPOSED IMPROVEMENT LOC/�TION:
Address: 1;1 QA 4kto,(ars k�( ;r,\ e-,2 f4' Pt-e,rcz..�F t � ►��
Property Tax ID#: 3t-1i:t.-�) So3•-000 6— oz--t-,— t Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DE�SCR�IPTION Of WORK:
h,n 1 ---tom 11 vi � eP � -t,cic U�� l�- ►�e,��'
CONSTRUCTION IN'FORMATIDN:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
Electric _Plumbing _Sprinklers _Generator f Roof Pitch
Total Sq. Ft of Construction: '( Sq. Ft. of First Floor:
Cost of Construction:$ 10,0Q0 Utilities: _Sewer _Septic Building Height:
OWNER/LE=�SSEE: CO�� N�C,�TiO,R:
Name _ cOseeh C>0-A-Sevy& Name:
Address:_ 5`1a� /�1e�}r sirlt��- Cc Company: ttl
City: 1�-4 P'ewu, State: Address: il� 3 S,,,y ( :s4
Zip Code: 3-6 `oZ Fax: City: dr-4 ,S4 State: F I
Phone No. Zip Code: 349197 Fax:
E-Mail: Phone Noll S1 Q(,-0 9S (,:
Fill in fee simple Title Holder on next page (if different E-Mail Nr► c_I%Ae— f2c6F,/L' e 4 rzkeo. e&--,
from the Owner listed above) State or County License 13,11'10
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
WVJ4,YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
(ao"_L 0 6LJ2
Signature of Owner/Le /Contractor as Agent for Owner Signature of Contractor/Li e Holder
STATE OF FLORIDA STATE OF FLORI
COUNTY OF COUNTY OF
The fpfgoing instrum nt was acknowledged before me The fgrygoing instrum t was acknowledged me
this day of 20_ by this5f)(J`day of / 201y by
C�t Vv V
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifi ion Type of Identific
Produced Produced L
:P
(Sign ure of Not Pu ic- tate of Florida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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