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HomeMy WebLinkAboutBuilding Permit Application U All APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` Permit Number: O o0o ` = RECEIVED Building Permit Application OCT 01 2019 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: OPOSEO 1 `PROVE01'�T LOCAT : Address: ee� v f e- _ Legal Description: Qvee,--?s c— ()"/;z / - >3k" A5 5���� of/ 7114t .� 6 n� ZNGG��t� /0 1z Property Tax ID#: /y/"1- 70/ . .00 y4- Doo '� Lot No.. Site Plan Name: Block No. Project Name: Setbacks . Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: / // ('r2okL wK e-' ✓ 6.5 vooj2_ � CfaNSTR+UCTION INFORMATION: Itiona wor to a per orme under this permit-checK a that appy: 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:$ ,/, Utilities: —Sewer —Septic Building Height: M=113/41110011 CONTRACTOR. Name v _3X � c Name: Address:� Q�� '' v e-,+%a C C6mpany: �7a/� City: %r� �,��. 0� .._... State: Andress? /(7 Q ee.� `'�¢,rW; Gt Zip Code: Fax: .��� City: n,� �,r2�.L�' State: Phone No. 77,2- 332- 1151 Zip Code: 3 L9 /S Fax: .�1.4 E-Mail: 5P�9o;,r{Gby;/�6h-S �GoHc,.ea�,-v(e-� Phone No 77a-•33Z- 1 ),q L Fill in fee simple Title Holder on next page(if different E-Mail SGo,,00i� -h�'; lel�� from the Owner listed above) State or County License 666_ )a,5SS3 z- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT' NSTINve I©N LIEN LAW fNf=ORMW N. 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencinR work or recordinrgyour Notice of Commencement. SigrEOF Owner/Lessee gent for Owner ature of Co ctor/License Holder STLORID I STATE OF ORIDA COF C COUNTY FL4 CL- The forgoing instru nt was acknowledged-before me. The forgoing instr ent was acknowledged before me this-A'-day of G 20 by this_LL day of 204 by Lt'� Ai Name of person maki7OR tement. Name of person makingg statement. Personally Known Produced Identification Personally Known x/ OR Produced Identification Type of Identification Type of Identification Produced Produced ( ignature of Notary Public-State of Florida (Signature of Notary Public- 4q% of Florida-Notary Pub is ,,��.YP+ KART g NIELSEN *_ Commission GG 20748' Commission No. :,� "a�' tate of t@A a-Notary Public Commission No. =p oe� t� EW)nmission Expires _* *� Commission N GG 207484 +nii��`� June 12, 2022 PS My Commission Expires 'nnm� June REVIEWS FR P RVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED �-e-v-. 8/2/17