HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -3 10 Permit Number: CEVED
C
- Building Permit Applicatio rl
AUG 01 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential _
PERMITTYPE: AIC Cm ea +_
`PROPOSED IMPROVEIVIEIVT:LOCATI'ON:
ff
Address: 9 406 Aryeli e1 / AJ. Pvr4 LI.tiCi ''L It- 349 F(
Property Tax ID#: 3�J 22 5E�2 C90 5(abC7 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION`OFAINORK.
4Z_a.Q�cC 1 Q ?Awe rne�f� - �r��`_ fir' D �K� �
1101 1 1 �C.-l4 IN( in(LoQv-
;'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:$ S�(�f� Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: ;. CONTRACTOR:
Name r✓hU 1C� N1i�2 S Name: A^
Address:'A40-CL-M erQA UA Company: JAck-- dr 1�. Bz F-Le
City: Vbi+- S+. .fhb State:*-'l_ Address: Il I<do SK) bi 1+try)CC, SA
Zip Code: 344—' IV Fax: City: PO r+-99- LL&4e, State:
Phone No. (Pl ct 1 Zip Code: QW18 q Fax: 331p ci b 3
E-Mail: Phone No 1O 901'�o6
Fill in fee simple Title Holder on next page(if different E-Mail 30 )(-- f0S-W6 f''CA.q Q� a®` • CO(ri
from the Owner listed above) State or County License CA G a t 511$
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 CONSTRU.CTION.LIEN LAW INFORMATION: -
DESIGNER/ENGINEER:
NFORMATION: _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 YORR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of O ner Lessee/Contractor as Agent for Owner Signature of Co r ctor/License Holder
STATE OF FL=A STATE OF FOR DA
COUNTY OF .�A • tr u COUNTY OF 4�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this��day of J i ,20�`i by this F�day of J �' 20 " by
Name of person making statement. ame of person making statement.
o r_tn .1 a cov
Personally Known OR Produced Identificatio N Personally Known_ OR Produced Identificatio ° �
Type of Identification �y o ype of Identification N c�N
Produced o• Produced 43 N 1 N
a �'
t0 0,� 4 J E o
E 3
oiaX 2t0om
(Signature of Nory Public-State of Florida) rQ (Signature of No ry Public-State of Florida) I w
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Commission No."6, -Z2-513 (Seal) ��g Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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