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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ®� .�� Date: 1-/ Permit Number: 19 RECE Building Permit AppliLese SEP 2 6 2019 Planning and Development Services itting Department Building and Code Regulation Division r, 2300 Virginia Avenue,Fort Pierce FL 34982 Lucie ou nty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial PERMIT TYPE: PRC+3'POSE� IMFR011EMENT LUCATi©N: Address: S h t''(5'f � • ezercc, c�vZ Property Tax ID#:;,-A(7LA_5 n (p lo4— 000 lq Lot No. Site Plan Name: Block No. Project Name: DETAi,LED DESCRIPTION aF WORK: CONSTRUCTIC INFORMA 1UN: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator X Roof 's%z- Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ -,.9,oe�j, 6� Utilities: _Sewer X Septic Building Height: OWNER/LEMSSf - .ANTRA Tt?R, Name / GC✓/ Name: 0 6 U N)4O um' XJJ, _f Address",,; ._ .::! ` 'e�.� �:`;" Company: ./t l AA'(C. J�j A 2 ICU, ; State:City: y Zip Code: tea '-s� `' - city`: ►�t L�-yJltr(/l�l�' �' 1' State: Phone N` a1;^c K� �>*i&��+ :+" r Zip Code:'_��0 ,l Fax' E-Mail: -A ' 2W yy/ /• Phone No � .-w✓� �i S3 S Fill in fee simple Title Holder on next page( if different E-Mail Cofvf - �A- 've- b + iL.( Lb^ from the Owner listed above) unty License CCG l 3 0� El Stat r Co 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. 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: i City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDAVIT: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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." S gnature of Ow er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF �O A 5\,__ STATE OF FLO COUNTY OF j ( /�� \ COUNTY OFO� The forgoing instrum Vt was acknowledged before me The forg ing instr ent w s acknowledged before me this 4-,7_day of J 20# by this day of 20 by Da V)Nl�� Name of person makifig statement. Name of person making statement. Personally Known OR Produced Identification Personally Know OR Produced Identification Type of Identification Type of Identification Produced D L-,- Produced T'Aln (Signature of rotary u lic-State of Florida ) nature of ot� W I ic- a NOVA Commission No. o�`dYP' , ELLE( �UGHN Commission N ?o Nel�ryPubllC St af��o5d ate of Fl ri a-Notary Public ; ';: Irtilon O 65 =* *= Commission # GG 270079 My COMMAWM Nov 6,2019 a-) GommissiNm ".04.9"WAMU if Run. October 22, 2022 REVIEWS F. R PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.