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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO gMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: &_'AL),�( 1 Permit Number: c9 RECEIVED Building Permit Application JUN 2 0 2019 Planning and Development Services 5T. 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 PERMIT TYPE: . Address: Q Property Tax I i 2'"#: I K21-� [61 &-6o o- 3 Lot No. Site Plan Name: Block No. Project Name: --E o w r r A 2C� �- 6 Lan. . 1'CAK 64-t, S, Lc_S (g 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:, lFyQO-oo Sq. Ft. of First Floor: Cost of Construction:$ �?0700 .@© Utilities: _Sewer _Septic Building Height: Name ',. Name: 1 Address: O S t/\U � Compan cy6�Gt1 L?- City:�(j-r� r PLL,C C, State: Address: `L�0 &L^C' Zip Code: :3 Ll JS Fax: City: D rf f State:EL Phone-No. AA Zip Code: ?.Vq 97 Fax: r E-Mail: ala Phone No 22 2 - 21 ro - L3 l �D Fill in fee simple Title Holder on next page(if different -E-Mail Si , :p m ��::� S � 0.0 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. -1 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 LE E N ATTORNEY BEFORE RECORDING YOUR NOTICE COM CEMENT:' Signature rFLORIDA ner/Lessee/Contractor as Agent for Owner Signature of ntra r/License Hold e'r- = STATE O STATE OF FLORIDA COUNTY OF -4 L �(I Jrn COUNTY OF TheZdayof ing inst ment was acknowledge before me The fo oing instr ent was acknowledge before me this 201A by this day of 20M by Name of person making statement. Name of person making statement. / Personally Known OR Produced Identification Personally Known OR Produced Identificationy Type of Identification Type of Identif' n Produced Produced (� r, 44 ` (Signature o - (Signature of No I' ' KAREN S. NIELSEN ,�``YP�''. KAREN S. NIELSEN °�'� `A= �J Commission No. �`�`°� °���State of Florid Q@ry Public Commission r�z :State of Florida-N(c� Public , ,12p7484 _. ac' ommission Commission# GG 207484 ;n e: Corrimission Ex ires My Commission Expires :�E o".� My p June 022 REVIEWS IllVISOR PLANS VEG EA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19