HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -\ 14\ Permit Number: \4d'A
RECEIVED
COUNTY
• �' A SEP 13 2Q19
Building Permit Applica ion
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
PERMITTYPE: dL
P OPOSED IMPRt01/EMENT LOCA ' ON.
Address:
Property Tax ID#: Lot No.
Site Plan Name: I� �" Block No.
Project Name: LAI?, �--/rwT L Irvi��� �'t�G-0` m I„ LLCM
D TAILED DE=�SCft1PTtOO Nc�O WOO RK:
uwark—
Additional
CONSTRUCTIO N�FORMATION:
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'
r
Total Sq. Ft of Construction: /00 Sq. Ft. of First Floor:
O�
Cost of Construction:$__ �i 30o . Utilities: _Sewer _Septic Building Height:
OWNWER NSSEE: CONTRACTOR:
Name °( ,� Name: �.�� VU O ^_C,
Add ress': _ sw "''''G"' �vc,� �d�`e. Company::
City: State: . Address`,''e�.; tip,:. L :�!' /'✓net..
Zip Code: _13 1 _ _.Fax:" " � City: State:1:7
Phone No. `'� �� Zip Code:
E-Mail: ze :� Phone No 17,51`r- 6W_005Sr
Fill in fee simple Title Holder on next page(if different E-Mail dwv �--;t Col"
'from the Owner listed above) State or County License �0 3M
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.
S PPLEMENTAL CONST UCTFRN RK LAW INFOR ATION
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 ofa. 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.1 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 T OBTAIN FINANCING, CONSULT
WITH YOUR LENDER R ANATTORNEY BEFORE RECORDING YOU IC OF MMENCEMENT."
Signature of Owner see/Contractor as Agent for Owner Signature o tractor/License Holder
STATE OF FLO DPA \e STATE O FLORI
COUNTY OF � . `.O c' COUNTY OF �b
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of P 20 N� by this AS day of 20A� by
q 4 � -'\'.s O f%fv,\ 0 �'-4 3 -
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifi tion Type of Identifica ion
Produced 1D L Produced
(Signature of Not ry Pu - aof Flor GG0220. (Signature of Notary '"� to of IQ EG
+, :�"'•. p�(CO MISSION# _ MY COMMISSION#GG 022023
• :p�tnber 16,2020 ;*; ;�.' EXPIRESM1B,2020
Commission No da Po; o No�rypublieUnderwdle� ,ommission No. ..,oP. ^ UnderMters
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19