HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO�MU,,ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �- ) Permit Number: I I �J � � I D 1 .
RECEIVED
AUG 0 8 ?D19
Building Permit Applica WRcie 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 ReSidQntial
PERMITTYPE:
PROPOSED IMPROVEMENT EOCATION'
Address:
Property Tax ID#: �� `I �- ��:JIJ J ` ��j"l �t i� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED-DESCRIPTION OF OR =
i
; e
rr fn
` U J
0
[C97NSTRUCTIO 'N-'INFORMAT-ION-.'-."
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric Plumbing _Sprinklers _GeneratorRoof 'Q Pitch
Total;Sq. Ft of Construction: '_� 2200 Sq. Ft.of First Floor:
Cost of Construction: $ Utilities: Sewer, _Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name ,d Name e ) I, t'CIAM
Address: Company: C ' C1
City:: S State: Address: I/J
Zip Code: Fax: City: PrCe State:
Phone No. , - Zip Code:. Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail 2
from the Owner listed.above) ' State or County License w-0 a
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 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.
Inconsideration of the granting of this requested permit,Ido hereby agree fhacl 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 Y.WR NOTICE OF COMMENCEMENT."
Sig ture of Owner/Lessee/Contractor'as Agent for Owner Signature of Contractor/License Holder
STATE OF FL R D ` .• r STATE OF FLORID ° �/
COUNTY OF�� _ [�1 ' �P,1 COUNTY OF Ilea h 1)/yr
The forgoing ins ume t w a knowledg efore me The f oing instr ent Nas c nowledg efore me
this day of 20'by this�day of 20 by
Jazz) - VAU WkL 1 S
Name o person making statement. Name of person making statement.
CM
Personally Known OR Produced Identificaticg\<q Personally Known OR Produced Identifications
Type of Id ofca i n � Type of Ide 'fic tion r Q U- C
=kAl
m 9U., P d ced `C T � C�
> oc�7 � w
� a1 m � 0 x
r � Q a � Zt!) 8X
ignature of No ary Public-Vate of Florida ) Z y v w (S na ure of Notary Public-State M Florida) a
Commission N 1� (Seal) ; �=� Commission No G � (Seal) i ya
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW -REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19