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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 1 \C Permit Number: RECEIVED I I y - Building Permit Applicatio19 Planning and Development Services ST. Lucie Eeunty, 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: PROPOSED IMP' 011EMENT LOCATION: �^­40� WN 1 Address: / `- - - - - — -_� - - -- - --- Property Tax lD#: s.-TL!O'���W66- 1 Lot No. '1 Site Plan Name: Block No. Project Name: ©ETAI'LE® DE-N,1CRI PTI=NW nRpK: r'�1M.tie!nIl1J J1�W!Vf)�(� •�`+L�t� �3:�'\Tt.�7 ��� F '117! ��{ {'j Vti✓ �V X���f%vl%`°`s U.° ® -! - PJ�� B\✓j9NW�1��hU,Y Y� .. CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: Mechanical Gas Tank _Gas Piping _Shutters - _Windows/Doors _Electric Plumbing _Sprinklers _Generator _RoofPitch Total Sq. Ft of Construction: 0 Sq. Ft.-of First Floor: O Cost of Construction: $���. Utilities: -Sewer _Septic Building Height: OWNER/LESSEE; CONTRACTOR: Name Ur"UE MOORS Name: � .' 1 /• Address: 4019 .City: T ,„ ry °State.: •,Address � -,Yb,+ V aJ 6 11-i a� •. ky 2 �,iyP Zip Code: 7 Fax: r _ .. -_ City a�-�,:':: Stateip : Phone No. v -. Zip Code;. )-. :' r Fa x: "7 � �� �� E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different' E-Mail L.-q V V Q 1�4 a �����p� 'CC Vh from the Owner listed above) State or County Licenseif 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. SUPPLEMENTAL.CONSTRUCTLC?N LIEN LAW INFORMAT'I�JN: 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 doth;e 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'bnd 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 usos 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.".. KIMT e \ , Signat'ureOof Owner/Lessee/Contractor as Agent for Owner Signa?tur .of;ConfiCact /Licens.e Holder � r. STATE OF FL IDA _ STATE OF FLORIDA COUN1Y COUNTY OFAA R-k, OF . The forgoing instrument was acknowledged before me The rg ing insti- ent was acknowledge efore me this aNX day of IaA� 20A by thi day of 20�Cqby Gb� Name of person making statement. Name of person making sta ement. / — _ Personally Known V OR Produced Identification Personally Known 10 OR Produced Identification Type of Identification Produced. Type of Identification Produced Uh (Sid ature o Notary Public-',State.of Florida ) (Signature ootary Public-State of FI• i o.Notafy Publ�3taleofflaidr Seal) ' avter Santana � Commission No. -S Njq�ar Public State ofF MyCommi 4iorrGG29o744• rybell Martinez Expires 07/1&2022 ' ` • My Commission GG 2708 5 or ti Expires t 0124/2022 REVIEWS FRONT-•" ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW1. REVIEW " REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19