HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
I% Permit Number: q r, (
�' ,•_ i6,1
Building Permit Application
JUL 2019
Planning and Development Services Pertnittin
9 D,ap4lcment
Building and Code Regulation Division St. I!c:e Ounty
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓
i
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:,
Address: 0% 05- 1� e,k)C1�,i.t � � � u.j� (T v�
Property Tax ID#: 14,) — '(x,( , —taoLot No.
Site Plan Name: , Block No.
Project Name:
DETAILED-DESCRIPTIONOF WORK
W t 1odlye Skwcc ) C-ea c of horn e,
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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: 'Sq. Ft.of First Floor:
Cost of Construction:$ t(oW` . CSU Utilities: _Sewer _Septic Building Height:
O;W N E RAESSEE: CONTRACTOR:
Name o�� � �(a,.� 2� Name:''Ceas `f- c'c g.64— C,4+bA L' C.
Address: 5-74-3 Ctot tomcti-; C6a&g 128 Company: __)ayYtco'cr
City: n i1, o State:_ Address: 3AgC) QL�,e�rye_
Zip Code: Q=om A.—( Fax: t . .. City: k State:
Phone No. J I " 5(0115 - (D k _ Zip Code: 249(5 Fax:
E-Mail: Phone No
Fill in feesimple Title Holder on next page.(Af different E-MailJA �CeaSu�� Co ,a"Cu��o►itr � �'�� C
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 CONSTRL"CTION 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."
Signatu, JFRIDA
er/Lessee/Contractor as Agent for Owner Signatur f Co tractor/License Holder
STAT r STA OF FL RIDA
COUNTY OF � l.�l.��� COLIN
The f�'�oing instrument as acknowledged before me The forgoing instrument was acknowledged before me
air-
this '(UU day of 20_9 by this 1 0 day of 20�y
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known . OR Produced Identification
Type of Identif+' o �� Type of Identificatio
Produced IJ �V C Produced �D L_- y�
(Signature of Notary Public- ate of Florida) (Signature of Notary Pub' - tate of Florida)
Commission No. (Seal)— Commission (Seal)
ELLEN VAUGHN
°<< ori a-
`State o
,�G 2 0079 =*
REVIEWS s, E�y �In Ex iP VISOR PLANS TION SEA TURTLE Aq ROVE
' + 1 om '° rE 2022 W REVIEW E�IEW REVIEW J71k IEW
DATE
ELL
``O1p0.Y PU�l, _.
RECEIVED
DATE = Corprpis" rida-Notary Publi
COMPLETED ''jOFF�OP M °p #Gr)
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