HomeMy WebLinkAboutBuilding Permit Application I {
All APPLICABLE INFO MUST BECOMPLETEDFOR APPLICATION TO BE ACCEPTED
Date10\2'-::z) i ` Permit Number: All
. . ^, RECEIVED
--- - OCT 2 5 2019
Building Permit Application
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)46271578 Commercial Residential
PERMIT TYPE:
::"PROPOSED IMPROVEMENT-9, ��ATION, kffia
Address: ,
Property Tax'{D#: 'i��� — � ' " Lot No.
Project Name:
DETAILED
0U,
I3ESCRIPTI0F WORK '
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CONSTRUCTION INFORMATION N„
Utilities: _Sewer _Septic Sq.Ft.of First Floor:
Cost of Construction:$ 1 ZC Q out Total Sq. Ft of Construction:
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<FLOODPL`AIN DEV WP VIENT PERMIT for str'u tureseexe�rlptxfrom�Building�Code'that3are�ln the
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NonresldentialFarm BuIIdIn ; � TempBldg/Shed.usedexclusivel for construction
Mokiile/Mo"tlula;r for teinp.construct on offic ��.� Bldg:"involved M istrib oaf electi icl ;.:,
aOther,:' ,,�. f& »F ooZone•� � '"` BFE , Floodway?Y N ICY
`6"'k lse Certificatelth.supporting ata�attached?rY/N'"r '�" �� i � : � S
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"All other applicable s ate and federal.permlts hall be obt fined prior toIxoinmeneernent}of
constructiian " . "" ', ,a t''a. x w"" .•,a , . , .. o �Y 'w 1J' "R
;'tea h . , r SCO TRACTOR 4., * +\
OWNER%LESSEE r Y N ru . E k
Name 1 Ct Name• C
Address: �� �"F Company..aZ_GC_r
CityCx State: Ad ess: f •+-7 _��15 �" t-
Zip Code: ����� Fax: Cit 5 �-�C_t�@ State:_
Phone No. �S 1` Zip Code: Fax:
E-Mail: Phone No-r-n= —T,)—?Xs
Fill in fee simple Title Holder on next page(if different E-Mail`�f C L�Gt �."' rc.SZ�O-
from the Owner listed above) State unty Lice se �'�g_Z`1
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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SUPPLEfV� NTALCON'STRCJ`CTION�UEN°LAW°I'NFORMATI4N
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DESIGNER/ENGINEER:- _Not Applicable MORTGAGE COMP _Not Applicable
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Name: Name:
Address: Address---
City: State: C' State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not A cable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Pho Zip: Phone:
OWNER/CON CTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that rib 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 1 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 jobsite
before the first inspection. If you intend to obtain financing,consul.t.vuith_lender or an attorney before
commerIcing-work-or-record.ing your Notice of Comme
Signature of Owner/Lessee/Cot ctor as Agent for Owner Signatu�of Contractor%Liceri a Ho der
STATE OF FLORIDA STATE OF FLORIDA .—
COUNTY OF /C COUNTY OF
The for ing instr as acknowledge before me The f r ng instr t as acknowledg before me
thiday of Z0 by this day of 20� by
Aoq�'L_?Inx'� 1 L )6LI ?19mcps
Mame of person making statement. / Name of person making statement.
Personally Known OR Produced Identification V Personally Known OR Produced Identification
Type of Identifipati Type of Identifi n
Produced Produced bl
A Al
�—
(Signature of (Signature f f 1�,Publt�of FIAti �E N
��`Yp�/, KAREN I LSEN
,� a, tate of Florida-Notary Public
Commission N _° `�=State of Florida- o ry Public = „`
207484 - Commission # GG 4
fission � � Commissio v (E�@fit
Qc oe; mission xpir s
;9. Q My Commission Expires °'R�1°10`` June 12, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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COMPLETED
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