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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED D Date: Permit Numb r• t JUL 16 2019 Building Permit Appli "Frill tting Department Planning and Development Services St. Lucie Count , FL Building and Code Regulation Division y 2300 Virginia Avenue,.Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: r Ch PR� POSED IiMRRO EMENT LO TION: Address: q C\n4 1 UIC1 Obl"n 1 F r+ Fufrr 1 Property Tax ID#: A2 1 I (� (� )– 00 Lot No. Site Plan Name: Block No. Project Name: - DETAILED -M5CR+IPTION 01=WORK: CONSTRU -TLf,ff JUNWARM TION: 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: Sq. Ft. of First Floor: Cost of Construction:$ , g © Utilities: —Sewer _Septic Building Height: 30W N it R/LESSEE: CONTRACTOR: Name jkji`tt 0,1()r.� Name: j( nes Address: Q Sera W1s ob':Sop Company:- '-S'uC'+--8 VA(Y t_l-fy City: f04i1i, trP_ - _. ._ _. - - VyState:f=(✓ Addre'ss:;-r-2 r=rte,-�,t�,1.5'�' Zip Code-!" r5 �', :Fax'. h if City: pcir� S�•:,a,:_��..; State: Phone No'. l.d"1`r.g, 3� ;�z�i (l�td':• Zip Code: 46C�_ __ fax: _ E-Mail: _ _ Phone No '77 Z—q Y3�3 Fill in fee simple Title Holder on next page(if different E-Mail 'fusoiGj'1 d(.n ir' ' b2LK7 2'-1-r 4-'0 from the Owner listed above) State o County License ,'r(. 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW IiUFOR+MAT1dN: DESIGN ER/,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 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Si nature of wrier/Lessee/Contractor as Agent for Owner Si nature of Co ractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The for ping instru was acknowledged efore me The f r oing instr was acknowledged before me this� ay of 201q by this day of 201q by rs- Name of person ma ing statement. Nam of person making statement. Personally Known '� OR Produced Identification Pe ally Known / OR Produced Identification Type of Identification Type of Identification Produced Produced ignature of N (Signature of Nota ublic-State of Florida) AUDREY B.HU PHREY - - ---------- - - - MY COMMISSI IyAgG 300$17 Commission No. :*_ Commission .Y' AUDREYB.HUM�I1(� ; • EXPIRES: arch 2023 °',? MY PIMISSION# G300 17 p fpF F°p Bonded Thru Notary Public Underwriters i off, EXPIRES:March 6,2023 ;F f;;'••` Bonde I Thru Notary Public Undewritors REVIEWS FRONT ZONING SUPERVISOR PLANS GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.