HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
— — - Building Permit Application OCT 24 ?0,19
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 _ X
PERMIT TYPE:
PROPOSED IMPROVEME LOCATION:
Address:—, Z 1rq,-,2 ,0V,� wcy
Property Tax ID#:J3 M )O—Sn o 1 3 3—060- 3 Lot No. 3�1
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
a n d •��� ,� ct �'1 eel
FCONSTRUCTION 'IN FORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows//Doors
Electric _Plumbing _Sprinklers _Generator XRoof �/>!2— Pitch
Total Sq. Ft of Construction:�` poo Sq. Ft. of First Floor:
Cost of Construction:$ 10, .�O Q Utilities: Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name It I' 61 AG Name: 1C1A ,I''-
Address:—,(, `762 `( ,v, e.[5 kjC 4 Company: c31r� , (900kinly
City:Tp I-2 f C c State: Address: I�1'I 3 c✓ 6tcleA a P S
Zip Code: 3u q. Z Fax: City: PD rf t=L' I'C State: T1-
Phone No. Zip Code: ��P�J 91Fax:
E-Mail: Phone No `7?Z`Z66" Sr6_5'
Fill in fee simple Title Holder on next page(if different E-Mail 6 c«n eDD• /1
from the Owner listed above) State or County License CCCf 13-�)17 D
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 Coun 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
OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
V�
Signature of Owner/Lessee/Co tract as Agent for Owner Signature of Contractor/Licens o
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-k 10Q.-e__ COUNTY OF ';-t 10L�,,e—
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �CA ,20f% by this(r)LI day of nC4 .201% by
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
(Signature of Public-State of Florida) Signature of&ry
Public-State of Florida)
Commissi
Commis
BRANDY MOORE + BRANDY MOORE
Notary Pub. o-State of Florida o`� '��Notary Public-State of Florida
• i( - o +�= omm ss on
REVIE y `cROM, Mai t ptre� r , + ��IA1 home ,20 [� MANGROVE
^�.,,, +r t� PERVISOR PLANS
REVIEW REVIEWREVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7119