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HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l' Date: Permit Number: "'t I RECETVCOUNTY Ci� LORI k Building Permit Application SEP 2 3 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 PERMITTYPE: P OPOSED IMPROU M �N LCICATION: � �, Address: Pro pertyTax ID#: C) to�� Q`1�Z" —� Lot No. Site Plan Name: Block No. Project Name: (;j5-NC6-- DETAILED D ASCRIPTION OP ©RIK: LT AMT1lRNL' : lllllllll ION: Additional 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 ' i Total Sq. Ft of Construction: 1U�NZ l' Sq. Ft. of First Floor: Cost of Construction:$ D S 6 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: TJ/ (6 LL— Name:? NC�� Name Address: Company: C610 -(---L, City: (ffuC Stater Address: - W kN . � Zip,Code:,3�� _ Fax: City: State: Phone No., 40 Zip Code: � J` Fax: E-Mail: 4�0, � /J - (nV1*L.eWl Phone No S(v .S�7.� 3� Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License .56� 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. SURPLEME�NTMONSTR YlIffilION 193, 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 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 THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YO DER OR AN ATTORNEY BEFORE RECORDIN OUR NOT OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA4— STATE OF FLORIDA COUNTY OF I COUNTY OF �,� yalL The r ing instr en_t Was acknowledge before me The r ing instru nt acknowledged efore me thi day of 20 by thi�day of 20�b /N / Na a of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifi a Tdn11 Type of Identific Produced LL= Produced CZ (Sign ture of a (Signature of Nota Pu lic-'State of Florida �'P'�., KAREN S. NI.ELSEN ���„� Commission N S�`P �,';State of Florida g@�$ y Public ;1pRYPV�, KAREN �N,�ELSEN { 7 Commission No. .o to of Flor 9�! tar P =* ommission # GG 207484 y ublic =� or "5 Commission # GG 207484 My Commission Expires ;q� o; �'"` "`� June 12, 022 REVIEWS FONT - ZONING SUPERVISOR PLANS ' ' VEGE E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19