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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q Permit Number: Dater Q( - RECEIVED ,Building Permit Applic ionJUN 1 7 20i9 Planning and DevelopmentServices ST, Wcia County, Permitting Building and Code Regulation Division ----_-- 9 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential .v PERMITTYPE: DEMOLITIOW PROPOSED IM�PR4UEMEN LOCATION:: Address: 11004 STERLIWA COMT . FoRT ReAce K.-W F140 Property Tax ID#: 1406Zv 807. 0087_ 000` Lot No. Site Plan Name: SIASMTON PUS17A Block No. Project Name: SONES DETA�t_EC? DE�SC� I�PTION {+)F 1NOR,K: CO STRUCTION NFORMAT`ON: 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: O _ Cost of Construction:.$ y� Utilities: —Sewer —Septic. Building Height: ©WN.rCR,7%@§ SEE. Cl?NTRACTO'R: Name ,,YE �.. • �NE.'S Name: TIL P.O. ^^rr-- Address: _ 0 S •1WA Coma Company: � Eity:` Address a >1 V `w Cov F_ .. Zip Code =Fax: ? r ' Cityf; 1!' State:73 ••� .Q ti x Phone No'~ • � �Zip Code. Fax: '� 'Phone No �� Fill in fee simple Title Holder on next page (if different E-Mail w)s • from the Owner listed above) State or County License C&CO 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 CONSTRUCTION LIEN LAW INF(ORMATIQN: DESIGNER/ENGINEER: V lot 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 the permit holder to build;the subject structure which is in conflict.with any applicable Home;O.wners A,ssbciation:rules;hylaws.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;iri all respects, perform'f6e 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 anoth&nori=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/LjOsedKontractor as Agent for Owner Signature of Contra for/Li rise Holder STATE OF FLORIDA STATE OF F1QfWA COU r COUNTY OF 4-a" Un 4&CIL OF — I �L" Df\ The forgoing instrent was acknowledged before me The going ins ment was acknowledg before me this�day of 20]R by this day of 20±1 by • C U1�,� �g 0!5&9. l VF.f NE Name of person making statement. Name of person making statement. Personally Known N,""'OR Produced Identification Personally Known \/ OR Produced Identification Type of Identification Produced Type of Identification Produced (Sig atu of Notary Public-State of Florida;): (Signatu a of Notary.Public:' ate Florida ) Commission No:(9 7U 1:- (Seal) ==- Commission No.(-� J� r Notary Public Stote of Florida ip`I � Notary Public State of Flo%i,. `" Marybell M rtlnez Marybell Martinez +� =My Commiasi n GG 270975 MY Commission �1 dF Expires 10/2 022a Ex it GG270975 REVIEWS FRONT'" ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE M ' COUNTER_ REVIEW- REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED' DATE COMPLETED Rev 2/7/19