HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: -t 6 C\ Permit Number:
RECEIVED
AUG 0 6 ?019
Building Permit Applicatio
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 Is
PERMIT TYPE:
(�-a 5 6. Q a4
PROPOSED IMPROVEMENT LOCATION:
Address:So L 4 L< <t A-6
Property Tax ID#: 3-32-7 - 7&- 0Q Z 7 Lot No. 7
Site Plan Name: _PQb) 2-9 a,-+ Yjl, � V�, Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Tea,r 0 sa ( o D rr�Q 16 K -7
a VL 5 4-r, )"l e u) /4 k-`7 J-26 6 Com Pct G -t V-a5:'l-e- dka'-�r
[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:
o
Cost of Construction:$4 3 5? 07� Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name fi r✓! de, J'�p Name: 6, t& R c0 S
Address:_ 5�Oq / Ir-� PL Company: 96 ��rc�cn - 1 o&r P--,,4r4 >LC
T
City: &C4-5t - State: PC- Address: S'/ 5t,--/ Sov7'L, AL-c�do 6(yd
Zip Code: 3 q q Fax: City: A - S't' L.-)c' P State:
Phone No. '77Z^ '-'(6 S-- 7 7�1 Zip Code: lq9llo Fax:
E-Mail: Phone No 772- LOY 57368'
Fill in fee simple Title Holder on next page(if different E-Mail !`gyu��o�e dooms p�,ff s Q�0.K.00 .c
from the Owner listed above) State or County License -10-3 T
11
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Ar)plic�a6e
Name: /' Name:
Address: / Address:
City: / State: City: State:
Zip: Phone/ Zip: Phone:
FEE SIMPLE TITLE LDER: _Not Applicable BONDING COMPA Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Z 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOT CE OF
A
Signature of Owner/Le ee/Contractor as Agent for Owner Signature of Contractor. lcense Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF COUNTY OF S�._ L vr�\k
The forgoing instrument was acknowledged before me The fUoing instrument was acknowledged before me
this day of 4 %rn .20_ by this b day of 20_l\ by
G,.\ b -rh 6 I 1\ 6 S G-,\ b-,sto � � 6—s
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_ L Produced
(Signature of Notar ublic-State of Florida) (Signature of Notary Ilc7 - a
-- DE r�NA MARIE GIVE
EGIVENS �; � � :'g`'' h1YG S^ION#GGD22023 i
Commission No. �a 'S i� #GGp'•2D23 Commission No. ,: QQSa l
7 0<;:...: '•, QySIDN EXFIr�� dcembe;1ti,2020
2, MY COM
Notapublic Underwrite-
EXPIRES:De to 16,2020 BondeTru
Undenrtes
Bonded r:ru _
'REVIEWS FRON •f S ftit## UN ERVIS0R PLANS VEGETATION SEATURTLE MANGROVE
COUNT REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19