HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lv �U/`� Permit Number:
OCT.2 8 X019
Building Permit Application Permitting DeAd�m
Planning and Development Services St.Lucie coupty Ment
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE:
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PROPOSED IMPROVEMENT LOCATION , F �t 5`
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Address: /317 3q'S?k
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Property Tax ID#: '1D 9 - 7e7 3 - 0/2 Lot Na. 11 l
Site Plan Name: 46_0 "' I
Block No. �0
Project Name:
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ED,-,DESCRIPT#O,N tOF W{ RK Y }rte
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CaNSTRUCT(ON 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 5q.Ft of Construction: �y Sq.Ft.of First Floor:
Cost of Construction:$ � �/ 7 Utilities: Sewer _Septic Building Height:
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OtiUNER/LESSEE r CONTRACTOR r
Name _ ILL! M. 1464 Name: 0 0 C'2 i. ,. u�1 z0vo,6
Address: 1317 <G(�}>✓�J [�� . Company: t. c�/ �I `y`
City: 0IT- t etc r StateAddress: RY&Y S. �V.S /,/&'X
Zip
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Zip Code: 3(1�792/ Fax: AJA- _ _ City: 402V- S7'". L Ur-tL State: )t17L.
Phone No. 772. .5�� � /� Zip Code: 3 cI9S 7 Fax: Al
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E-Mail: Phone No 7Z z., ,3 .i ZC Sr
Fill in fee simple Title.Holder on next page(if different E-Mail 5�--q2F Z c/�/ L2
from the Owner listed above) State or County License 5CC 13 LIS S 2,1.5 r%
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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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SUPPLEMENTAL Ct3NSTRl1CT1ON LIEN LAW iN.FORNlAT10N °f#
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DESIGNER/ENGINEER: 4 Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: I
Address: Address:
City: State: City: State'-
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address: I
City: City:
Zip: Phone: Zip: Phone:
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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 usel
"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 COMMENCEM T r
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Signature of Owner/Lessee/Contra or as Agent for Owner Signature of contractor/License Holder
STATE OF FLORID STATE OF FLORID�
COUNTY OF Luc_, �e.- COUNTY OF
The fRRring instrument was acknowledged before me The forgoing instrument w acknowledged before me
this `� day of U� c �� .20� by this-CE95-127 f_ .20_T
&Kv c C DuA,�'WOLD/� JVL_ c� � C
Name of person making statement. Name of person making statement. '�—
Personally Known OR Produced Identification_t Personally Known OR Produced identification
Type of Identification / Type of Identifi atiorl r
Produced ('i l/C P !^aC26i Produced_ `t MR
(Signal a of NotEWPublkiJtli)&11 P11011011 Cull"i (Signature of Notary or a
Joshua De oe
YP Jos a eVoe -MY COMMIS �X1{7605
Commission No. MY cow#GG3I7605 Commission No. extmtRF :Marrl$Y3 2023
OF EXPIRES:March 28,2023 ""Cf�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE `
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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