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HomeMy WebLinkAboutBuilding Permit Application All APPLICA,UIE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED IIa�r Date: �' 1� Permit Number: RECEIVE® Building Permit Applicatiori JUN 19 2019 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PR©POSED I�M,,P OUEMENTITdMCATION®; Address: 42� //U) cpki moi/�/--- . fog/ •d Property Tax ID#: x4f� DO 7q-,/ Lot Lot No. Site Plan Name: Block No. Project Name:. DETAILED DWGRIPTION OF WORK: . rGLCG n' CONSTRUCTION ('NFORMATION; Additional work to be performed under this permit–check all that apply: —Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors W Electric :' _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor:-. Cost of Construction:$ NO�� Utilities: —Sewer —Septic Building Height: OWNER/LESSE CONTRACTOR; 12 Name Name: c jai :.Address:' 1062, _r.: :,...-h...'�_ -_--Company: City: pwMCPJ State: Addre//s��s: r,�.. Zip.;Code: i3`��Q) _`;rFax City: i�iS�l f .a1 1t/e/Fjii�. State: rZ PhoneN.o: _ _Zip Code: Fax,: E-Mail: Phone No . Fill in fee simple Title Holder on next page(if different E-Mail Ti �' V r LL'• 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$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLE ENTAL CONSTRUCTION LIE LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address:, Address: City: City: Zip: ''y Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County mak kno.representation that is granting'a.permit will authorize the permit holder to build the subject structure which is in conflicttwJ h ariV applicable�Hgme Owners;Association roles,ibylaws of,and covdgRA. .that may,restrict dr prohibit such structure. Please consult with yqur Home•Owners Association and review y'o,ur deed for any'r"estrictions which may apply. In consideration of the granting of this requested permit, I do•h`ereby:agree that l,Vtli l,'�in`all res'pe`cts;perfoi�m•the work in accordance with the approved plans,the Florida Building Codes and'St'. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structure swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use "WARNING TO NER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FO IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED HE JOB SITE BEFORE THE FIRST,IN!$PECTION_ IF YOU IN D TO OBTAIN,FINANCING, CONSULT WITH LENDER OR AN ATTORNEY BEFORE RECORDING 1�0 T E 'COMMENCEMEIIIt",, Signatur of Own see/Contractor as Agent for Owner Signytu f Contr for/License Holder STAT OF FL0 IDA STAF FLO IDACOU TY OF CO OF The fo oing in tru ent was acknowledge before me The for-going instru dent was acknowledge efore me this day of 20 by this day of 20L�by n Name of person —Ming statement. Name of perso making statement. / Personally Known OR Produced Identification ✓/ Personally Known ,,OR Produced Identification Type of Identifi n Type of(dent' ' tion Produced Produced VL ::�t t6,L" A (Signature'of Notary"Pub•Iic St` e 'f ignature of Notary Rub i - • . i NIELSEN �ti,arn�a., N S'.A IELSEN � hXAR`EN.S:= ; ;_� _State'oY;Florida-N taryPubli Commission No. .��o�PPY'Pba�-,Sfa&_Wlridkh-Notary PUbI C - 0748 mmission No. Com�6ie81�n# Gd 207484 .j F ='• ="Comri)ssion,#fQJ, :,� Q�,� M oFF�� yCdriari�is'sion Expires ,,9,� Q, y;Corn.m,i,'ssion xpires nm�`� June 12, 2022 REVIEWS FRO N. 0PERVIS0R PLANS VEGETATION SEA TURTLE MANGROVE NTEf, ,,;REV14W,.E>,« .b I�VIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED Id DATE COMPLETED ev. 4,.