HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: ��' s " `� Permit NumbV �
I .
LINTY VRECEIVED
• OCT 15 2019
- -- - - Building Permit Applic tion
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie CO t)/, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:Gh
FRO�POSE�D IMPRO�u�MENmT�C�O�C�ATI,ON
II
Address: 2303 wA/tdS Qc)
Property Tax ID#: d 3 ' 6 0 19 , O G 4 - ? Lot No. !
Site Plan Name: Block No. 2
Project Name:
DETAI,!_E® DE�SCRIIPTIN OW
late— ,0_ 10
C 4A.A.Qe
CONSTPI I(, 0N,IN.K.0"'IATION; }�°' r
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:$ 15y $D• Utilities: —Sewer —Septic Building Height:
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�.r".,t" 'o�e'T � �
01NNER�rSS;EE. IA-4 � 3CONTR`AC�TOR� �
y 6; `b �J."R:'z., :937
Name_, A�w Me SWeems Name: M&A K iNA,%
Address: 23o 3 EJUACds RJ. Company: 171n•p ,l ��•4 Cati�.''��`�•i ,�+�•
City: � 040e P�Ft. c Re,a State: t L. Address:_5'?(, 10" A&x f G�
Zip Code: 244$2 Fax: City: V--JAO I3[Ac1 State:
Phone No. 1-12- cj 1 )- 11 S 3 Zip Code:324 4$ Fax: Q i J - q& 4
E-Mail: Phone No 719 - D b 3 $
Fill in fee simple Title Holder on next page(if different E-Mail 0 DL? fO •. A IT. /1 L T
from the Owner listed above) State or County License CA< I bI 7 $ 3 b
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.
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SUIPPLEMENTAL CONSTRUCTION IENLAUU INFORMATION:
DESIGNER/ENGINEER: yNot Applicable MORTGAGE COMPANY: _ of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ of Applicable BONDING COMPANY: _&415t 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 thepermit 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."
Signature of Owner/L see/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
The for oing instrwy�ent.was acknowledge fore me The for oing instry=�ient was acknowledged-before me
this�day of 0C_f" 20 y this day of U Cl' 20,rby
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Id n ' i ion //11� Type of Identi icati i
Produced Produced
(Signature of No Public-State of Florida (Signa I'c- t to o Florida)
9
Commission ;°�}""Y`69��= AUDREY B.HU Y Commi 'a11 vp4 " AUDREY B.HUMPHREY
ISSION GG 00817 OMMISSION#GG 3008`17'
9r: EXPIRES:March 6,2023 EXPIRES:March 6,2023
on ed ru Notary Public Und rxriters ! Bonded erwri ers ;:
REVIEWS FRbNT'MMTC ` PfRVISOR PLANS VEGETATION SEA TURTLEMANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19