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HomeMy WebLinkAboutBuilding Permit Application f - All APPLICABLE /INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ryry co'�--��j Permit Number: "fid Date: FC�IVJ;f�`T !' JUL 18 2019 Permittin • t 9 Department Building Permit Application St' Lucie County 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 V PERMIT TYPE: Fe Ylee L11PROPOSED tMPFtOVEMENT LOCATION: Address 0.1 S C1 n N'1,Se -1. Property Tax ID#: r0 0&6 q—00 6 9 Lot No. Site Plan Name: Block No. Project Name: DE1SGRIPTI®N O)=WORK':/ c' �'l l` 4 c �'1'1Gc-c 1/V 'Jo u b le drive 4 C l ) /D `Aa"(r_ adztl_,e CONS�TRElCTION INF S',MATtONs 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: �J Sq. Ft. of First Floor: Cost of Construction:$ �d � Utilities: _-Sewer _Septic Building Height: Aft OWN;ERJLE�S�SE�: CONTRACTOR: Name Jer 0.tJlS Name:_ IJ1iI IC he a (�et I ��^ Address' . .g;a:, 25 H cs�YEti'� Company:, nLNl(1 O Jbn COvt�Yet Gfl✓�', City: State: Address: Zip Code 3 S/`7 Fax: City:'.; d+ Pi:e,2Q State: Phone No. Zip Code; Fax:' E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail Nwk (�►�O t,Idtoeog fi4,a*f M,- from the Owner listed above) State or County License 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 C©NSTRU TION LIE LAW INF(�JR+MATIfJN: 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 TOO ER: YOUR FAILURE TO RECORD A NOTICE OF INOTICIVOIF CEMENT MAY RESULT IN YOUR PAYING TWICE FO MPROVEMENTS TO YOUR PROPERTY. A NOTICEMENCEMENT MUST BE RECORDED AND POSTED N THE.JOB SITE BEFORE THE FIRST,INSPECTION. IFTEND TO OBTAIN.FINANCING, CONSULT WITH UR LEN O AN BEFORE RECORDING Y MMENCEMENT_' Si ature of Ow er/L ssee/Contractor as Agent for Owner Sig t e of Co or/License Holder STATE OF FLORIDA STA OF FLORIDA COUNTY COUNTY OF �1'• LUC�e OF The ffof,��oing instru ent was acknowledged before me The fo going instrume t was acknowledged before me this`T'"'-day c !.!✓tom 20 f� by this W1 day of (4jll-e 20//1 by M11 J , 7 ��� �ch Qz1 _ W���r/' Name of pG�making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced ® �J—ig`nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) mmission No. 'ok JAMES WETHIN(ffftOR. ..F•' JAMES A. HI TON,JR. * * Notary PuNlc'Slate of Florida Commission No. PUN �,� Commission No.GG319860 ry. arti Commission Expires 04/04/2023 * *, Commission No.GG319860 dP 12023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW . REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19