HomeMy WebLinkAboutBuilding Permit Application C:
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'SUPP'LEMENTAL CONSTRUCTION LIEN LAWRINFORMATION
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.
1 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 YOUR LENDER AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM CEMENT."
Signature of Ownd7 Lessee/Contractor as Agent for Owner Signature of Contracto cense Holder
STATE OF FLORIDA ) STATE OF FLORIDA �P_� - I
COUNTY OF ��2%//1/ COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrume t was cknowledge before me
thi A day of 120 /6 by this ay o 20 by
L6�1�2 �9�oa ,&5 2 4 N�"4/2pv Mt
Name of person making statement. Name of person making statement.
Personally Known_Z�013 Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signat re of Notary Public-Stat of orida) (Signature Notary Public-State of FI id )
Marsha Ewing -
NOTARYPUBLIC Marsha Ewing
Com (Seal) Co (Seal)
OF FLORIDA ���
a Comm#GG03 __S
STATE OF FLORIDA
to Expires 10/17 020 om OGO 8
REVIEWS FRONT ZONING SUPERVISOR PLA 9,VE ATIM71 t�TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Zc3'7 Permit Number: e'70
0- ---(52)
Q RECEIVED
Building Permit Application SEP 2 2019
Planning and Development Services oeparl""'
Building and Code Regulation Divist.on Permittng-e cou"t\'
2300 Virginia Avenue,Fort Pierce FL 34982 St.Luct
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:
PROPOSED I M PROVE M EN_rl_OCATION" ,'.
Address: —L—L- A C4 ("a La 'V� 14 q s--?
Property Tax ID#.- 4:s-4. 2 k I- coo'--1 ov G 6 Lot No�
Site Plan Name: Wa :t_r /V\-Dor-A Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: .,
oi-
e, J
11 Y C.L t C_L, 116C' JP
ufI �jc-t- �nps
.CONSTRUCTION INFORMATION:,
Additional work to be performed under this permit–check all that apply:
—Mechanical Gas Tank Gas Piping —Shutters Windows/Doors
Electric Plumb[ C —Sprinklers —Generator Roof Pitch
CAO 0 3,7 5%
Ft 10 Sq.
TMaq�F`l of Const Pcrt�i o q I V CA\ Ft. of First Floor:
Cost of Construction:$ VMoo Utilities: —Sewer Septic Building Height:
n
.OWNER/LtSStE: CONTRACTOR .-
Name Name: ciz"r SqK10%10A
Address: --?--L- A a u Company: Th A'm
City: State: Address: e: \,�m q S 4-C. X11
Zip
-U-
Zip Code: 1 4 9 Fax: City: � State:PL
Phone No. Zip Code: S49c11 Fax:
E-Mail: Phone No 2-7 1) 2-7 12
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County LicenseIJ
-
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.