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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l .n- ��,• "li Permit Number: NO WMTM- _ Building Permit Applicati n RECOVE Planning and Development Services JUN 17 2019 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi6ntia PERMIT TYPE:' �� PROFUSED IMP^^ROUEMENT LOCATION; Address: Property Tax I D#: JJ 1��J -C� ®oo Lot No. (�F Site Plan Name: K ',,,J\n r' 9- e , Block No. Project Name: DETI�1LED DE.�SC��IPTION OF WORK: ac V[ V)\-[Ll I �0 0 � 1 V\ -ems rYl- C© TRUCTION 1'NFOR0ATION: 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:$ 0100 Utilities: _Sewer _Septic Building Height: OW ER/LE-SSEGONTRACT.- Name .rQ 4 1 Name:' �yIC�V �V t S Addres_.s<:- _ f7. v Q Company. !`_► �G S ; .cA j:.Cx� 4r '. City, 0'!r-1r : 0State: Address n' ,Zip_Code: City: P; �'; State: ` ' Phone°No:_- .L�[2 ,:" (.; 9 Zip Code: Ul (DA E-Mail: Phone'No- , Fill in fee simple Title Holder on next page ( if different cl-m Q r 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. SUPPLEMENT L mMMUCHM LIEN LAW 1NFORMA►TION. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _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 the permit 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 YOQR LENDER OR AN A]TORW BEFORE RECORDING YOUR NOTICE OF CO ME ENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature ontractor/Lice -se Golder STATE OF FLORIDA STATE OF FLORIDA COUN7 COUNTY OF OF wo' _ The forgoing instr4ment was acknowledge efore me The forgoing instru ent was acknowledged before me this a day of 201 by this day of 204 by Name of person Making statement. Name of pers n making statement. Personally Known OR Prod=d Identification Personally Known OR Produced Identification Type of Identification Produced b(_ Type of IdentUk-ation Produced (Signature of Notary Public-State of Florida ) (Signature of Not I Commission No. ,��avP ,� KA EN S. NIELSEN KAREN S.. N6ELSEN =°,�m�,, �\�=State of Florida-Notary Public Commission No. ;_° ��sState of Flori(f�N tary Public s` a Commission # GG 207484 ommission # GG 207484 "` "' ",,o,; � My Commission Expires it OF,�� • My Commission Expires June 12. qn502 REVIEWS FRONT ZONING OR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19 poll :3�{�-'Y� ,<,::..,,t 1 t< "rt••nr^-^y m.st-s"'rre'*i tai L+ .5k'S;Y Al . .� low -'' .r +'F 1•:n,`'s:}t,s;.ta3,1 r7t,,,. s,.,y tr a :kr.. 't i+e:I. b, � iS'.y h,a.K �,r+,t 5..7 �1i s. r riJ°Sent i,,t7``YS �1r'd§,�1r 4i St i s l:*r•k ,�,:ak{'�E•,:.+ tf s 4a?,�o,re�; -,s �1. 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