HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO BE ACCEPTED-
Date: 1 •3 • 19 Permit Number:
RECEIVED
-- Building Permit Applicatio n OCT 0 3 2019
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: rr--
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PROPOSED IMPROVEMENT LOCATION'...
Address: 'Z(��1Z 1'Y1n`Irtc WL
Property Tax ID#:��� ��L jf) �� ®�y Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION Of WORK:
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
il
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 50 Utilities: _Sewer _Septic Building Height:
OWNER/,(ESSEE: "CONTRACTOR:
Name t> Name:_ - 36N^ lxeZC1gr_k0
Address: ct Company:LJ
1 GL=
City: Stater Address: o2l,2f.., SkJ IQ2i ire
Zip Code::5-5 Fax: City: 04 Sr. ILC, State:FL
Phone No. L -7q VpZip Code:
.3c-iat S 3 Fax:
E-Mail: Wf&nr- Phone No `7?2-!5Z9 ZIZq
Fill in fee simple Title Holder on next page(if differ' E-Mail YOctr C CC ,C@
from the Owner listed above) State or County License
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:
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 YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOBS FORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YO ER R TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Signatur Own essee/Contractor as Agent for Owner Signatu a of Contractor/License Holder
STATE OF FLOR STATE OF FLORIDA
COUNTY OF LUG° !E COUNTY OF (,Lkdk(✓
The oing instrupent m1as acknowledge�efore me The fo� oing instrument was acknowled ed before me
this day of 20 by this 1 day of 2011 by
o�n G-e�zc C,Va
Name df person making stateme / Name of person making statement.
Personally Known OR Produced Identification ' Personally Known OR Produced Identification WN
Type of ldenti #io Type.of lden ification
Produced ProducedYL24A
(Sign rept, of ryRA f,l5�t ( nat r to P -c S t��Y��!i ��
=o/ :State of Florida Notary Pu Iio tary Public State of Florid
Comm `= Commission # GG 20748a1 Kayleigh Bogert
-r e: on Expi(� ) CommissioVN0.1-M00 �? P �nmission GG 274003
;;� JJune 12, 2022 OF expires 1 1/05/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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