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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:�aa` � Permit Number: T - RECEIVED JUL 2 2 2019 3 Building Permit Applicat on ST, Lucie County,Permitting 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 PERMIT TYPE: mob, PROP'©SE� I'MPROUEMENT LSC N Address: ZLI, ip X '1 ron Un i s Ave-hu vu -zF : - r-E- �eLc�-�-�(,,2r( 1a 3UeU Co' PropertyTaxlD#: �`'1a`� "�10 a.-Og�3��dU -� Lot No. Site Plan Name: Block No. Project Name: DETA{LED DE�SC �IPTION OF 1NORK; CANS RUKI I NA INFORM TION: Additional work to be performed underthis 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:$ 2CO,D D Utilities: —Sewer —Septic Building Height: OWiVER/LESSEE: CONTRACTOR: Name —�'->>° (-15q 'Press `Z. Name: Address: 21eleD -e—, Company: City: F04 eV-C State Address: Zip Code: 34 q('L(, (Q Fax: City: State: Phone No. C-1-1 2) 3--�-z— 333 3 Zip Code: Fax: E-Mail: a v,_0_ if q 32-Ua'i 1,cav" Phone No Fill in fee simple Title Holder e.n next page'(i different E-Mail 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. WINFIR LEMENTAL CONSTR+UCTIUN Ll LAW "T - DESIGN T 0 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 iristallation 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 fwwill,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 SIT EFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A TTORNEY BEFORE.RECORDING YOUR NOTICE OF COMMENCEMENT." Signa f Owner/L4sske/—ContractorV Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thi s,)-a— day of-_5 20 A by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced 1. 1 . Produced (Signature of Notary PL61id - NMVIAR1EGIVENS ignature of Notary Public-State of Florida) tv q r. - 7 �• �� �Y�gr�rnlsslor��,:o Commission No. iia *2 Eg;peceMber'16.2020 ission No. (Seal) ,E�FF�o°•'- Bonded Not2.11 PublicUndenurit.r J REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE . RECEIVED DATE COMPLETED ev. 2/7/19