HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
• JUL �� 2019
- - Building Permit Application
ment
Planning and Development Services P�r�S�+ti.Lucie
f�epa ntv
r7`.r LUGIL�COIsilL`,�
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: I
PROPOSED IMPROVEMENT LOCATION,: ;
Address:�,-7 Q Gn Qnq nn
Property Tax ID#: I ""� �'63� b _ 7 Lot No. a94f
Site Plan Name: Block No. K'`
Project Name:
DETAILED DESCRIPTION OF'WORK
�- Cb
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 Roof Pitch
Total Sq. Ft of Construction: gt10c� Sq. Ft.of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
OWNER/.LESSEE '` CONTRACTOR:
Name C Name: CA
Address: 3 d-1 Company ,r ;n aR'n
City: i �S e1c-2��, State:e-C-1 Address: (�7.3 s o
Zip Coder L ci eY2" Fax: City:P 6(� SC't* t 4<- State.
Phone No. Zip Code:3 ti 2U Fax:
E-Mail: Phone No-7W-—0(,t---, -55C5
Fill in fee simple Title Holder on next page(if different E-Mail SI.xbs ;e\ oQ�A..3 o b-c o-\
from the Owner listed above) State or County License f 3�
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.
r
SUPPLEMENTAL;CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGIN pp MORTGAGE COMPANY: Not Applicable
EER: _Not Applicable cable
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 YOURIENDER OR AN ATTORNEY BEFORE RECO DIW.4eMR NOTICE OF COMMENCEMENT."
Signatur o Owner/Lessee/Contrac,or as Agent for Owner Signature of Contractor/Licen a Hol er
STATE OF FLORIDA STATE OF FLO A
COUNTY OF fadIra COUNTY OF da/k.,
The forgoing instru nt was acknowledgedbefore me The fgSgoing ins ent was acknowledg@ before me
this day of 20 by this ISM day of 20 1� by
kl� �" P�anm daw
Name of person making statemerW Name of person making statem .
Personally Known v OR Produced Identification Personally Known x/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
#Ina di f �'_L qlAa
(Signature of Cojaw Public-State of Florida) (Signature of o ry Public-State of )
(�(�1 gp1WAY a��, BRANDY MOORS �c� q Floridato ide BRANDY MOORE
Commission No.W 10 f �,' °�(Se®d�nmisslon#GG102839 Commission No�� �V�� I *� �Seal�ommissionkGG1028 9
N��� Expires May 9.2021 ' '� � Ex�,'ns May 9.2021n. of Bonded Thru B Be
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2