HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: p • 'TPermit Number:
RECEIVED
Building Permit Application AUG 19 2019
Planning and Development Services ! ST. Lucie Count Permittin
Building and Code Regulation Division y� 9
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PER'MITTYPE: ���,
J.PARM0,900-090= •C TI
Address: 5 r tr , �Ee 3 �—
Property Tax lD#: 3L4()7,- La Q ' 0.1 Mo. Lot No.
Site Plan Name: Block No.
Project Name:
D E3D D C lPTtt3N F 1NG3RK.
r
Ps_t wl rk V- 'Th r,65 o e Yt
I
C -TRU C3N I'N'"UO RM ON:
Additional work to be performed under this permit—check all that apply:
_Mechanical Gas Tank _Gas Piping' _Shutters• _Windows/Doors
_Electric _Plumbing _Sprinklers _Gen'erato'r" -_Roofs: Pitch;,;.,
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$�'�040,00 Utilities: _Sewer Septic Building Height:
CSI° . R/LESS � „ �• TRA OR:
Name 9XFOLON Name:
Address: Company:
City: :fa-- ,'-(,C1L State�� ,Y! iAddress
Zip Code: ��� Fax: )...t'' City: `" i `'"' State:
Phone No. ~
Zip'Cotle: '' ` ' ,Fax:
E-Mail:
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.
U ''PLEMENT 1.CONS R CTION L1�EN LAW I[V 'C}tt+MATIQ :
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 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
PO�TED ON THE JOB SIE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WI IH YOJJR LENPfR OR N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Si at re Owner/Lessee/ o tractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFI. S.�CI�_ COUNTY OF
— �!The fog oing instr ment was acknowledg before me The forgoing instrument was acknowledged before me
this day of 20� by this day of 120_ by
19) ez-,
Name of person making statement. / Name of person making statement.
Personally Known OR Produced Identification , Personally Known OR Produced Identification
Type of Identifi do Type of Identification
Produced ( Produced
(Signature of Notary Pub ic-State of Florida) Si nature of Notary Public-State of Florida)
\\wJ6 REN S. NIELSE
Commission No. ,P oa% S(fS � mission No. (Seal)
< ; a e f Florida Notary P �#
_* •= Commission # GG 207,134
a,
June 12, 2022
REVIEWS FRONT NS VEGETATION SEATURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
ev. 217119