HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED g /�
Date: (7� I Permit Number:
RECEIVED
R
_ Building Permit Applicatio JUN 2 0 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie Cou , Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: J q C
r19611
Address: 1 q q 1 'Ml�G(,AAf) '*
Property Tax ID#: 19 0� 503 od ZW 60�0 Lot No. 2,-
Site Plan Name: Nt2�7'N PV&X- f✓51 i�,S, Block No.
Project Name:
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Additi nal work to be performed under this permit—check all that apply:
%echanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing- -Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ �`� Utilities: —Sewer _Septic Building Height:
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Name JOn.,ol) LeVe-YZMAn Name: c,<T0I 1-
Addresss:// 1 � YYJJ4 LLQ h,� G� Company: )l //
City: I-JL Stater Address:� 901.0 .5` a� Jia, UV At
Zip Code:.�� �Z -'4' Fax I; City: Stater f
Phone No:' 3 JZJ'"S�lvr'�S�g Zip Code: �1 i�� •Fax:` �/'
E-Mail: ;.- Phone No._. :7.).. Z4.:.Z <). ..-- r1�> •.
Fill in fee sirripleTitle-_Ho.lder:on next-page(i.f different E-Mail CY) L /7--IF
from the Owner listed above) State or County License 4401 V/ 234 :1
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.
Imo` y
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 YOPq NOTICE OFCOMMENCEMENT."
Signature of Owner/Lessee/ ontractor as Agent for Owner Signature of Contractor/Li ns Ho der
STATE OF FLORIDA STATE OF FLORIDA _
COUNTY OF (I I f=, COUNTY OF
Theor oing instr ment was acknowledge before me The for oing instr ment was acknowled before me
I day of �`(� 204 by this day of 20 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificptirup Type of Identificatisfl
Produced L Produced L,
i
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No KAREN S� gLSEN
a, SI�� Commission No. (Seal)
��of Florid -No ary Public �,w,rrrFlorid -No ary Public �� ,
Commission # GG 207484o�P�YPJao, KAREN S. NI
,
June 12, 20 2 ^� •= E orl a-I� tary Public
oma:
REVIEWS SOR PLANS VEG lyr r,r�� °� MaFS'sion �AXP� VE
COUNTER REVIEW REVIEW REVIEW RE RE�D►&it1/12, z 22
DATE
RECEIVED
DATE
COMPLETED
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