HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 9
J � -� - RECEIVEDBuilding Permit Applicati n OCT 2 3 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V
PERMIT TYPE: '2-wc
PROPOSED IMPROVEMENT LOCATION:
Address: t'i
Property Tax ID#: 3 ` C� 130 - v Ob --Z Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION--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 ✓Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ CCS, Utilities: —Sewer _Septic Building Height:
.OWNER/LESSEE: CONTRACTOR:
Name Soh ji, Name: Q
Address: Company: J
OA-
City: (-A State: Addre : 1773 SW C -S-Ir-
Zip Coder Fax: City: L4 &y/ e- State:l' (
Phone No. Zip Code: 34R67 Fax:
E-Mail: Phone No-77Q- oW '75-6S-'
Fill in fee simple Title Holder on next page(if different E-Mail e qA& yetm,
from the Owner listed above) State or County License LQ 1,33 /`70
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 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
W"rH,YQII^JXNDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signa ure of Owner/Lessee/Cont s Agent for Owner Signature of Contractor/License
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo oing instrt5 as acknowledge before me The r oing instr as acknowledged efore me
this day of 20_0 by this day of 20�by
Miles
V�1
Name of person making statement. Name of person making statement. /
Personal) Known OR Produced Identification Personal) Known OR Produced Identification V
Y Y
Type of Identif' ion Type of Ident' ion
Produced (� [� Produced I _ L
p ��J
4 AA
(Signature of 7SE
/4 (Signature of Notary Public- tate of Florida)
KAREN S.
e�Estate of FloridCommission N ��`1arv1�,, KAREN S. NiQ �N
Commission *_ sion ;_ �: tate o Florida-Notary Public
My Cornmis '* Commission # GG 207484
June =a
on _xpires
REVIEWS FRONT ZONING SUPERVISOR PLANS V _ June 2 ROVE
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