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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED od.- Date: PermitNumber: - P. 4 Building Permit Application AUG 19 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 PERMIT TYPE: C. ( C JEL�, iQCA1� � )PA-7J(2 PR4POSED IM ROUEMEN LOCATIO .- Address: ` Property Tax ID#: 0 9 2-433 50 2 ' OD C(/ 0 0 D O Z Lot No. Site Plan Name: Block No. Project Name: DETAI ED DE-�SCRI'PTION O WORK: AM jel� CONSTRUCTIMN INFO �11tOMNI, : Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank- Gas Piping _Shutters _Windows/Doors f/Electric _Plumbin'g _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 2600'`x© Utilities: _Sewer _Septic Building Height: ftWN'E�R/LESSEE: -M CONTRACT"/O�R: Name t6 co1cf-6op— , Name: IV -5 —�Z 3% ��L Address: 3 � % �✓�E.�C '.. - Cly Company: _ City: rl �lC�?C� State: rZ Address: 2,6 20 Z_C�C5�' Zip Code:. 3`t� Fax:' ' City: �f qq L�� Stater Phone No.- T7 Z 2-16 — ZzgD Zip Code: Of Fax: E-Mail: Phone No 7 3.24, Fill in fee simple Title Holder on next page(if different E-Mail <f c- C from the Owner listed above) State or County License x300 7 � 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. FP AL CC COMMIUMML +moo 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-arid'covenants tfiat 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 OU INTEND TO OBTAIN FINANCING, CONSULT WIT R LEN'_R OR AN ATJZRNEY BEFORE RECORDING Y01-URINOT11CIVOF COMMENCEMENT." ,Signatur of 0 ne /Lessee/Contractor as Agent for Owner LSiature o ntractor/License Holder STAT OF LORID OF FLORIDA COUN OF �(�,� _ NTYOF The forgoing instr ent was acknowledged before me The fo oing instru' ent was acknowledge efore me this day of 20 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 V Type of Idention Type of Identificatign.. Produced—t ' Produced (Signa ure o 6 ary Pulalig;.State (Signature of Not KAREN S. NIELSEN �``1YP'�/ KAREN S. NIELSEN Commi icor °Br-i -Notary(5080c Commission No. =_° `�_Statmmisse of iok"19 207484c =► Commission # GG 207484 ` M Commission Expires ��o;ore`� My Commission Expires .1iina 122022 'unn` June 12, 2022 REVIESUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.