HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'U Permit Number:
RECEIVED
Building Permit Applicati n SEP 2 7
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Per itting
2300 Virginia Avenue,Fort.Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential i•
PERMIT TYPE: c
PRQ'POSED PMPR0IJEMENT LOCATION: ,p
Address: 3781 S 05-L- S T 1 t-o/L-� U ` Q-C_ �'C- 3 6/'F S�
Property Tax ID#: a� a` .� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DE�SCRd'PTION OF WORK:
�/'�c�-►-� t S/cCe .re��Ce- — WoocC Go�C CqS`�
CONSTRUCTION INFO gMAT ON:
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: Utilities: —Sewer —Septic Building Height:
OWNERJLE�SSEE: CONTRACTt!7R:
Name o�-F1�e,r !` Akc-L J I Name:
Address: 411 'Company:
City: 0'-O 2� /" /-C-P- State:f'-C-;,. "Addr'ess: _
Zip Code: 3 Fax: City.; State:
Phone No. 9 Ce cis-9��3 Zip Code: Fax:
E-Mail: C S 60A ' Phone No
Fill in fee simple Title Holder on next page(if ifferent E-Mail
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.
MOWALC�O
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 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 alf 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."
re of Own e Les ee Contractor as Agent for Owner Signature of Contractor/License Holder.
STATE OF FLORID STATE OF FLORIDA
COUNTY OF Cz uc_, S COUNTY OF
The forrgoi„ng instr me t was packn�owI d before me The forgoing instrument was acknowledged before me
thi�_5—`d'ay oft/ 2 by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Idre�pication Type of Identification
Prodi cedW S Produced
(Sign are of KotaPu KirL Stat Jason e (Signature of Notary Public-State of Florida )
/�
C m fission Ne-la-70'y 3d laItxpIfes:February 23� Q mmission No. (Seal)
��.,,�••••����.�� Bonded Thru Aaron N tllry
REVIEWS FRONT ZONING SUPERVISOR PLANS „ -VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te—v—. 2/7/19