HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r �/
Date: CD �� � Permit Number:
RECEIVED
JUN 1.4 1019
+ ~
Building Permit Applicatiorpmitting Department erSt.Luc:ecounty
Planning P e sannin and Development mentServic I
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
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Address: /t3V66 bG3-obo_02 /<<c�&e ZZ
Property Tax ID#: '43 Lf 62 CRL5- 00��- 12Qp Lot No.
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
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Electric _Plumbing _Sprinklers _Generator _Roof Pitch
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Total Sq. Ft of Construction: /` 1-cC) Sq. Ft. of First Floor:
Cost of Construction:$ L? rq1 q Utilities: _Sewer —Septic Building Height:
A 2A
Name (2dmz l CSI✓i Name: R 4 '(�
Address: ��y1 � �y-brDcL W"'d� AWL0 Company: G-0 ,Icta/ &Ieai/11C t—t-c
City: p�v,T�(�,` � State:P C. Address: jO 70 -�'E �2��v 1-4 U-4-0 �-
Zip Code: __���g.o Fax: City: S"Kc-Y.1.P( State rcC
Phone No. Zip Code: Fax:
E-Mail: Phone No >_2— v3 3> 23-5 /
Fill in fee simpl'eTitle Holder"on'neztl-page"(if different E-Mail :i�.
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.
Vsoon=_- M
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."
Signature o ner/Lessee/Contr r as Agent fbn6wner Signature of ContractPlfricense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S� —U�CAA_ COUNTY OF S�L.0 fA�(
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of Z1'U/VP 20_1� by this day of ,U/1/ 20J� by
CA rJbS:� 'D VIN (tq�',
Name of person maki g statement. Name of person maki statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification _ ]] Type of Identification
0 Produced 'U 1. Produced, rr��
(Signature of Notary Public-State dUloricla ) (Signature of Notary Public-,State of Florida)
COmmissil N&yl ,, ELLE it\I VAU Commissi
Py
:State of Florida-Notary Public ELLEN VAUGHN
=* .= Commission #GG 2 =i° ,State of Florida-NotaryPublic
,9rFo Foe,, My Co mission Expire
ar Comm ssion #GG 2700 9
REVIEW ".� Ost,dd X22 ERVISOR PLANS V AI TICKY t s yq > ire NGROVE
UN ER REVIEW 4EVIEW REVIEW Y — EVIEW
DATE
RECEIVED
DATE
COMPLETED
�ev. 2/7/19