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HomeMy WebLinkAboutBuilding Permit Application SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION 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 MENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF OU,1 D T I OBTAIN FINANCING, CONSULT WITH Y E OR ANA RNEY BEFORE RECORDING YO NO CE\OF COMMENCEMENT n Signature o Ow r Lesse /Contractor as Agent for Owner Signaturtract r/License Holder STATE OF FLORIDA STATE O LORIDA, 1 COUNTY OF L2 COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 9,6 day of iLS .20A_ by this 11Q day.of 5Cft l bK .204_ by Name of person making statement. Name of person making statement. Personally Known_ ,OR Produced Identification X Personally Known OR Produced Identification Type of Identification Type of Identification Prod L N e Con+rrV_+ Produced (Signature of. ot NPublic-St of FI ida) (Signature of N a Public-State Flo ida) Commission No. (Seal) Commission No. (Seal) REVIEWS . FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. ��pv aye STEVEN LEVY Yp�B�n STEVEN LEVY Notary Public-State of Florida Notary.Public-State of Florida _n• �: F omm. xpires p ,2022 ofd My Comm.Expires Sep 5,2022 Bonded through National Notary Assn. Bonded through National Notary Assn. All APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Nu �� 'I"D R RE C" V t SECP 3-0 2019 Building Permit App ication Planning and Development Services Pe rm I tti n g Department Building and Code Regulation Division St. Lucie Co.0 n ty, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential PERMITTYPE: ) PROPOSED-IMPROVEMENT-'LOCATION Address: a,©l d�1 J&CC6 'D-'. Property Tax ID#: _ 1 <Z/0-7- QCAZ�5 j]of No.._ � i Site Plan Name: I'1L1YlIlV ICC\% Block No. Project Name: %IVAa 4 60% DETAILED DESCRIPTION OF'WORK L A 10 1C '1 & �— CONSTRUCTION INFORMATION:,.. 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 Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 6 .2-0 0 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR:- Name ` lan(w Kel"n Name: T3 2 Address: '101' SaiY alis ntd 'Dr. Company:analihl Ki'o� Vit')ti a City: -TSf� 9lette State: 'FL Address: foS38 Coll the Ave. Zip Code: Fax: City: mirk h i State: El, Phone No. q Sq Ssz -9(&1 Zip Code: 3314D Fax: E-Mail: Phone No $OU -7s3 '71110 Fill in fee simple Title Holder on next page(if different E-Mail �aLtrali+.i aaoPccfi1p t'z� amai 1-�wh from the Owner listed above) State orl6unty License CiAC1Sl8?�2 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.