HomeMy WebLinkAboutBuilding Permit Application I J a t-C,40-b
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: ,"3\ 403
Date:
f.YY RECEIVED
Building Permit Application AUG 0 2 2019
Planning and Development Services
Building and Code Regulation Division ��`. Lu le County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential'
PERMIT TYPE: P ` 1 i
PROPOSED tN1PEt01/EMENT,MLOCAT N' f
T � Y
Address: ( (D
Property Tax ID#: : `5+0 L `Cv(O -- ONO-7 _ Oo C-)- J Lot No.
Site Plan Name: Block No.-I Z
Project Name:
DETAILED DESCRIPTION OFf1NORK 1 x
,
COiJt�CC� �o G.1 ►Y. L�r��EI� 3T, L_Uc1El CbV
CC�NSTRUCTkq NFORMAT;ON 'F
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping ,Shutters _Windows/Doors
—Electric 4PIumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height;
OWNER/LESSEE x »_' r ;CONTRACTOR
Name `& k(u CAS5k-P, -Do Name: o a--,
Address: V �F'--y S VIIL.LIAMs Company:
City: Fof� T 1�- IE:jZ z Stated= Address:
Zip Code: Fax: City: State:
Phone No. 702 :3y2-- 21 Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if 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.
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or anscoveriants 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 i 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
-W-ffH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
SignIture of QwnerJ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA 'STATE OF FLORIDA
COUNTY OFCOUNTY OF
Theoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ly day of )<f _-,20 11, 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 Produced
(Signature of Notary�Ojblic-State of Florida
*Signature of Notary Public-State of Florida
Commission No. r
,G 0720-5 is
e 702o 6mmission No. (Seal)
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REVIEWS- FRONT
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SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTERVIIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
I COMPLETED
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