HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (1
Date: I _ Permit Num Bi-
Wvr.D
MR"ETErill
0 OCT 16 2019
Building Permit Appli C449tting Department
Planning and Development Services StLucie Count FL
Building and Code Regulation Division . yr
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROPOSE DIMPROVEMENT LOCATION;
Address: 2 S FU5PSOO \,rcnY
Property Tax ID#: LI $ -7 b2 — 13,9 — O oo Lot No.
Site Plan Name: Block No.
Project Name:
.DETAILED DESCRIPTION OF WORK: '
CONSTRUCTION INFORMATION:
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:$ 6 7 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE., " CONTRACTOR;
Name G.-w.3,epge :.�;.�o.�er�a-: ; ;:: Name:..... f`i.4..:L ui/►c�� �. ..
Address: Company:
City: .' �7y Cie: R:u is n,:,` el•. State: PL Address: 3:S o ak".
Zip Code: =3 313 3 Fax ='"` 'r' City: U.;!'�. P;�'ce ` State: r�
Phone No. Zip Code: 3ug LI 7 Fax:
E-Mail: Phone No 7-) ,l -(s6 G.�0 S00
Fill in fee simple Title Holder on next page(if different E-Mail VV}rCN 4-z_
from the Owner listed above) State or County License 13 OVy s S 1 7
Ifvalue 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 CONSTRUCTLON LIEN LAIN INFORMATION
i r
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.i.
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."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder.
STATE OF FLORIDA STATE OF FLORIDA .
COUNTY OF Lµr 'e COUNTY OF S,,,,,-4 "e-
The
eThe forgoing instrument was acknowledged before me The forgoing instrument Was,acknowledged before me
this 16 day of do l-o L,e�- 20J5, by this -day of 0c_-P obe.- .20II°I by
Lir.G Lel-aur�neac.�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
CLNotary Public State of Floride
(Signature of-N a) (Signature of Not P c fS te5s65
E Commission s 0212812 GG 185885 orw� Expires'02128/2022
Commission No. ' Neal Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW -REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.