HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:9 10I Permit Number:
FK�,r n r 71 RECEIVED
` SEP 16 2019
Building Permit Applicatio
Planning and Development ServicesST. 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 _
PERM IT TYPE: 0V&f, 41&—I)?j,) D1 6o n-
PROPtJSED l,1VIPRQVEMENT�LOCATION, ,TMt} fir. . d.s.. 41,
7
Address: q3
Property Tax ID#: , 5V7` 00a0-- ODO Lot No. IS
Site Plan Name: Block No.
Project Name:������/ /p�-�G�
"x� �� " x.
DETAILED DESCRIPTION QF WORK
a �s
—boo ng ri OA� 18--1�—c 7 fir; �1 /u/ y ,� 'y
GtaNSTRUCT(QN IN'FORM`, TIONg �` � ._ .
Additional work to be performed under this permit-check all that apply:
D -S'
Mechanical Gas Tank _Gas Piping _Shutters �-/ s/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: �,z Sq. Ft. of First Floor:
Cost of Construction:$ 3 66 Utilities: —Sewer _Septic Building Height:
ODUNER/LE5EEg ` CONTRACI"OR u
. . .
Name -7-/?-1'00-D I 11A-SS4 Name: "LA�I�ZC./
Address: 930y SCAIC/3O4�)l &H C ( Company: >4&Lzo) boons L)
City: 5�`. � ��E State:r=�- Address:1,T7 sW 5
-Zip Code:3.Yf Fax: rV' City: O l' o-givo-0 L- ` State:
Phone No. 3/' �. Zip Code: 3306Fax:
E-Mail: Phone No � �
Fill in fee simple Title Holder on next page (if different E-Mail b ske-e - Cx I I- CO rn-
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.
5UPPLEM.ENTAL CONSTRUCTION LIEN.L'AW INFORMATIONtl
-, .4 r'"
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.
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 TH FI ST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, C NSULT
WITH Y R LENDER OR AN ATTORNEY E RE RECORDING YOU NOTICE OF COMMENCEMENT:'
Si ture of Owner/Lessee/Contr` actor as Agent for Owner nature of Con license Holder
STATE OF FLORIDA !! STATE OF FLORID
COUNTY OF �tIQ,-. trCJ COUNTY OF to r
The forgoing instru ent was acknowledged before me The forgoing instru ent was acknowledged before me
this Z day of �, ))20_q by thiss day of 20 l` by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Id on Personally Known OR Produced Id 'cation
Type of Ident' ' ion Type of Identification
Produce Produced
(Si re of Nota r - r. nature of Nota r ubli -
Commission No HENRY Rqj g Commission No.
MY COMMISS ON# G193970
!. MY COMMISSION#GG193970oP° EXPIRES:March 16,2022
P°
REVIEWS FRONT ZONING SUPERVISOR PLANS EGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
i
i '
l