HomeMy WebLinkAboutBuilding Permit Application I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a — V/1
i
I
RECEIVED.
Building Permit Application lug 1
� 1019
Planning and Development Services St.
oepar mens
Building and Code Regulation Division permittingI_uc«'County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential I,-'—
PERMITTYPE: Shy- -�r.S
PROPOSED IMP.ROVENIENT LOCATION; t
n 3�
� Address: fa�� � 00 /�/�JIXt r �c��.2. �� V'�, f C�l� ��c� �2
Property Tax ID#: LILIa6-600- ODDS -000~ Lot No.
Site Plan Name:
/� Block No.
Project Name: de_ta;,& 4 • eiaL l
a..
DETAILED DESCRIPTION OF WORK
Ar0-C)"d i onsyrJ l g open enc_ '. r l:e'lr
I l c� GJ I►�rla�s y i 41499 .hl OCIL ADen,e)6 .
CONSTRUCTION INFORM _T[ON
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:$ l3 I ZZ Utilities: —Sewer —Septic Building Height:
OWNER LESSEE 5 CON7RACTQR _
Name 03t a Co Name: megrk- &rYL (L'
Address: )D�3 i (bou r 1 Company: 4__4 ShU__#e 1 G)Iaoks a td /)uus //1c
City:,Kim Address:_AP&OR f2CeSs Dr
Zip Code:., (5'40 Fax: ��6- LftO.114 4� City:�G•.0I+ State: r-Z-
Phone NO. 111-- Z`a 3-OS"_3- Zip Code: 3SLAO 4 Fax:-cipl-wy_061G
E-Mail: -- Phone No 9[ I, -7L/6z O 73y<
Fill in fee simple Title Holder on next page(if different E-Mail ��15�)l t f�e�s L L�2(LSot A•ne.+
from the Owner listed above) State or County License S Cc-1 S I I L(`i(o(o-.,
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.
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SUPPLEMENTAL CONSTRUCTIbN LIEN LAW INFORMATION
s
pp _Not Applicable
DESIGNER/ENGINEER. _Not Applicable MORTGAGE COMPANY:
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.0112 AN ATTORNE E-RECORDING YOUR NOTICE OF COMMENCEMENT."
Si nature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA&�Arn_ STATE OF FLORID
COUNTY OF aP/-- COUNTY OF FLORIDA/-)
COUNTY R-2C__C1—
The forgoing instru t was acknowledged before me The forgoing instrument was acknowledged before me
this�day of en20 lS by this l(o day of 20_' by
Name of person making statement. Name of person making statement.
Personally Known L----OR Produced Identification Personally Known t---QR Produced Identification
Type of Identification Type of Identification
Prod ed Produced
(Signature of Notary Public-S Yputed
S o�f�ryubk Sate of Fl tt a tgnature of mm ssion Nootary9;m.
GLA.GAETA
Commission No. 20� i`1 e�'Nmmission p lic-State of Florida
My Comm.Expires Aug 6,20 2 ion#GG 207111
through National Notary A n. Expires Aug 6,2022
a Iona o- -A—sifill
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TUR LMANGROOVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.2/7/19