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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date: 19 Permit Number: ^ JUL 0 3 2019 Building Permit Application ST. Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PROPOSED IM'PROUEMEN LOCATION: ��O Address: �f Property Tax ID#: ' ©,C�' ©�r�' Q�� � Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION ©F WORK: IL CONSTRUCTION I INS;;P.M RMAIN N: Additio 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:$ !!Ko,�o Utilities: —Sewer —Septic Building Height: OINNERJLE.SSEE: CONTRACTOR: /� Name mss` Name: / F,Mg4 /`i1&QiU&'((,1 Address: ..° .*3co•-2 - =;' 2�/(` % Company,:_ AeAla 'l C�.(zp. City: State:r Address: L 30'q3 !A&�� Arkl� Zip Code; �at�q 8 Z Fax: " City:�� {�tr�14�1/ "' `Sfate:� Phone No.: Zip Code:3qI g 1 Fak- 7A)- E-Mail: _ Phone No Fill in fee simple Title Holder on next page(if different E-Mail 3,t�Lead6A 6 4 Ac oL_ Com, from the Owner listed above) State or County License dA?LO/ `-z 3 e� 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. I SUPFLEME AL CONSTRU ION LIEN 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: 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. 1 J Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Ed b COUNTY OF The f�going instr en was acknowledg before me The fg�going instr ent was acknowledgeefore me this day of 20A by this�day of 20 11 by Ee cis F, Name of person m ing statemeNd. / Name of person making statemen / Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Iden ' ' ion Type of Identifi rl_&� Produced Produced (Signature of I o P - (Signature o N�tarr�r, u i - OSpHY �a1., N S. NIELSEN KAREN S. NIELSEN __ _State of Florida-No ' Commission Ni .B`o`a °B:', f Fiorida(S1aa�ry Public Commission �' •= Cc GQ iD�}�84 c °• Commission # GG 2Q7484 ;+� a ion # 4 %,���„°,.�` My Commission Ex My Commission Expires pires 2o— June19 REVIEWS O4GT VISOR PLANS VEGETATION SEA TURTLE tAGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.