HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0M .
Date: l Permit Nu
T RECEIVE®
JUN 17 2019
Building Permit Application
Planning and Development services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROPOSED IMPR01(EM ANT LOCATION:
Address: Zoo 1 ow C�
Property Tax ID#: 14f{ Z�— O � voc)•Z I—V V U . o Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DWCRLPTION OF WORK:
C Ye-4
CONSTRUCTION IN'PORMATION:
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:$ Jam( Uy- U d - Utilities: —Sewer —Septic Building Height:
OWRER ME�SSEE: CONTRALTO
Name C7�� `j,� Se,�Q� Name:
2U t�"� V e2y� .
Address: '�di, Company
City: 1�4� ., ,�ry State:_ Address. 3tf.3Z jW Flu
Zip Code: 3 y ;Q `': Fax:` City: r State:
Phone No _ Zip Code ��"r I Faz:-
E-Mail: " "" 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.
SUPFLEMEN1'AL 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: of 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contract r s Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
The for oing ins um nt was a knowledg d before me The f r ing i tru nt was cknowledged before me
this day o 20 by this day 20Zq by
S Gl
Name of person making statement. Name of person making statement. /
Personally Kn OR Produced Identification Personall Known OR Produced Identification
Type of Identification 1- Type o Idents ' a ion
Produced t¢- Produced
(Signature of Not AUDMPHREY (Signature of Notar P blic- e of-Florida)
'' • = MY COMMISSION GG 300817
Commission No. ' sati316,2023 Commissi n
}. ;PAU9fiE8.HUMPHR
Bonded Thru Notary Public Underwdlors ;#: MY COMMISSION#GG 300817
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