HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Permit Number: "/ �zp
RECEIVED
_ Building Permit Appli ation JUN 2 0 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial S ' U le Styr FL
PERMITTYPE: G0rYz_t9
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Address:
Property Tax ID#: �a ��' �� (� f �- Lot No. �c00
Site Plan Name: C /C Block No:_�c��ez
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
_Electric _Plumbing _Sprinklers _Generator -Roof Pitch .
Total Sq. Ft of Construction: 60 Sq. Ft. of First Floor:
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Cost of Construction:$ �,®Q� Utilities: —Sewer —Septic Building Height:
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Name Gr� �� e,35* -6, . Name:
Address: -I 0 �c� (LC Company: L
City: ('064 /r Al ci I.2 State: Address:I�e bzxGU� f
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Zip Coder Pax: City: Stater
s
Phone No; Zip Code:
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.
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 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."
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Signature of O er/Lessee/Contr ,r as Agent for Owner Signature of C tractor/License H
STATE OF FLORIDA - STATE OF FLORID
COUNTY OF COUNTY OF
The foI�o ng instru t was acknowledged before me The forgoing in ent was acknowledged before me
this v� ay of 20�gj by this day o 20 by
�bi ran �, e ,�r n ►-�
Nam of person making statement. N f person making statement.
Personally Known �— OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Ohtary Public-State of FI rida (Signature oT No y Public-State of Flo da )
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AUDREYB.HU ��,�� YCommissionY-COMMISSION#GAHI 0817 Commission
.Au46",. AUDREYB.HUMPHREY
EXPIRES:March E,2023 G300817
REVIEWS ZONING SUPERVISOR PLANS Cviq ;,, IWnde TF6Ao"fi ik8 Alois) GROVE
ER REVIEW REVIEW REVIEW IEW
DATE
RECEIVED
DATE
COMPLETED
ew.
PtanNng8°DevetoprnentSemces ASBESTOS NOTICE
Buildin 6i Code.Re ulaHon Division°
;,:2300,VirginiaAVenue'
Fort Plerce,FL 34982.:
Phone{T72►462 2172-Fax 02j462-6443
Asbestos Notice to Contractor
June 20, 2019
BSL CONSTRUCTION CO
BYRON LENOFF
5693 NW NORTH MACEDO BLVD
PORT ST LUCIE, FL 34983
RE: Building Permit Number 1906-0429-
It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
Signature
� e1
Date
6/20/2019 11:20:05 AM