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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I VAIJ 9 Permit Numb r• KtC. IVED r_ a s JUN 17 2019 Building Permit Applic ion Planningand Development Services e r . tin 9 Department artment Building and Code Regulation Division yl FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOO y. `M'PROUEME N IN LOCATION: Address: -5'-AA,l 7-A R,0_5'A PA Ck l�VA- 1--T PI C-RCE. 1✓L 3+?5/ Property Tax ID Lot No. Site Plan Name: ` 00 P_t3CJ1�� � ` Block No. S Project Name: �< C or DETAILED DESCRIPTION OF WORK: L 0 S L i L L S"�-�- Q AQ,2-d? JA&Z-t —Ery C-6- f2a� CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: �G� 6 C SL,L —Mechanical —Gas Tank —Gas Piping —Shutters _Windows/Doors —Electric —Plumbing —Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction:Yq ,4r, ( 2— ) Sq. Ft. of First Floor: Cost of Construction:$ DO Utilities: Sewer Septic Building Height: OWNER/LE=SSEE: I CONTRACTOR: N a m e -ML 'c—, (MPsCi°J Name: lee Address: �] P) 0 Qx>S� Company: City: 1%k State: Address- Zip Code: Fax: City: S t Phone No. �� �ZA'n-fj�"d � G��, � U ZiA�Ce- E-Mail: Cj f�Ql �. `^F 20 l��Li l.Cdc�-� P Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) Stat r County Lice se 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. I _ SUP'PLEMEN�"AL E©NSTRUCTION LIE�1 LAW INF©RMATlON•. DESIGNER/E GINEER: — Not Applicable MORTGAGE COMPANY: �Not Applicable Name: 1 Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEESIMPLE TITLE HOLDER: Not Applicable BONDING COMP NY: Not Applicable Name: / I/ii w L Z Name: Address: Address: City: but 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." e� 4,L-V-1 Signature of Owner/L ee/Contractor as ent for Owner Signat re of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instr was ack owl edged,pefore me The forgoing instrument was acknowl ged before me this day of 20 ,by this day of 20_ by N me of person ma ing atement. / Name of person maki statement. Personal wn OR Produced Identification'" Personally Kno OR Produced Identification Type of Identific ti Type of Iden ' ication Produced l r• ` t, Produced 61�,Wb (Signature of Nota Public-State of Flori a) U (Signature of Notary Public-State of Florida) Commissio Commission No. (Seal) ; •.. ....�: B.HUMP RI°Y ;. MY COMMISSION#GG 300817 EXPIRES.March 6,2023 REVIEW � teg ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER R VIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19