HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:- AIkIt- k�
Permit Number:
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RECEIVED
Building Permit Application SEP 2 6 2019
Planning and Development Services
Building and Code Regulation Division L ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
`'P,RC?'POSED'IMPFtOVEMENTLOCATiON i
Address: X401 p�n� c!c r�U t- -
Legal Description: L i1 d,r-n i{b, c_r �554-gtS
Property Tax ID#:3qo a--(t d'03 2q-Oao-.3 Lot No.2313 4
Site Plan Name:?-,dlne_r-t V rCr_k -f 1-r, Block No. 20
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAlCEND phESEft�FTlON OF WORK vow J y , zz rxr' ,`
h9N Sc- 6A Clad cGS) nO sG z'e,C Ao-y �
CONSTl3lJCTlON INFORMATION
f,._.,...,.:'S.. vA—."'.r.'l.J.r;T: Y,).l;.a. 1+ ._... . s+. V .% ..:.f} _ � _ 4-:•.=(. f_ .� f i '� S.•-
artoeormeunertitiona ispermit-c ec all t=appy.
HVAC Gas Tank F_]Gas Piping _Shutters Windows/Doors
c 1- _
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]Electric- Plumbing ❑Sprinklers F Generator o Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ ('f C17 3 . ? ! Utilities: Sewer Septic Building Height:
SOVI/NER/LESSEE' Y Y
CONTRACTC7R x
Name- re,_rke,t7t-cle Name:l "mo i► - t.�c�( {�c
Address:.SG O i 9r,,Qr�i g D[- ,v 8,. Company::..._f-i-C, C.,
City:- p,,_4cr_� Stater Address: i to
Zip Code: �L4,?FS at Fax: city: State: i PhoneNal 7a=gam -q({7 Zip Cade:_-,meq I D--- Fax:-5-L-1 4:/QS_
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E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: �,
from the Owner listed above) State or County License: �` (1-71.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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5U RUEME ITAL4C{�NSTRUCTit}N L(EN LAIN lNFORMA
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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:
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 wi'li autfibrize 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 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 jobsite
before the first inspection. if you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature of Owner Lessee/Agent - ature of Contractor/License Holder
STATE OF FLORIDA fSTATE OF FLORIDAf�
COUNTY OF f`. 4jel e- COUNTY OF a tQ J r l
The for oing instrument was ack owledged efore me The forgoing instrument was acknowledged before me
this�day of_ ! �1. PL 20 by this day of 20 by
-(Name of person acknawiedgin (Name of person acknowledging}
(Sign ure of Notary Public-State of Florida) (Signatur of Notary bl,ic�-Sta of Florida}
Personally Known OR Produced Identific tion Y Personally Known OR Produced Identification
Type of Identification Produced + y1ve �)LeV1S Type of Identification Produced
b�AarPu�r, AN LAYOUNG
Commission No(361306 I
{�fA.DgSaluo Commission Na. MY�siON FF 951069
ASTA 6F r=1 rwH)P,
NOTARY PUBLIC NT e EXPIRES:April 12,420
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Revised 07/15/2014 >' Expires i0/20/2o21
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW ,REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS