HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:ZO-2,9-19 Permit Number: ``�ys °�3
RECEIVED
Building Permit Applicati n OCT 2 9 2019
Planning and Development Services ST. Lucie County,Building and Code Regulation Division Permittin g
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
RWT?A \ 1\
PROPOSED IMPROVEMENT LO ATION: ,1--
Address: �,� //5 r D 17,4,4.r o+///' 2a �vVT �✓G l� �J/ J���,S�i
Property Tax ID#: 3u1\�' S la 033)' O d4 - Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
a-PI' Lt�T_Jr0 V CJ Cly Yi Cis X
.1
CONSTRUCTI.GN INFORMATION: j
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric U16umbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ /-160, 60 Utilities: -Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR_:
Name /torr orrt� Name:
Address: —_/0
0 /"d 2&." oll, Company:
City: /-Or/ JCr:64 State�� Address:
Zip Code:3 Fax: City: State:
Phone No. �-S2 -®/ Zip Code: Fax:
E-Mail: r--eaA& -C,IMev r / 0c/& 1we) ,Go Phone No
r'
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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.
11 1 SUPPLEMENTAL CONSTRUCTION [EN SLAW GINiFOR'M-�T�Mi . .
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: Not Aoriic�hhle Il
ne: I Name: I u
.. cc i acress: i 1�
City: State: I City: State:
!j ! 2ip: rnone j up: I'f I1711C. ! !I
H FEE SIMPLE TITLEHOLDER: Not Applicable I BONDING COMPANY: Not Applicable
II I MCI l IC. Tial ne: 1
A A-A I i•
-H Address:
cSSS:City: City: I l
Zip: Phone: Zip: Phone: I
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of wne Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA � STATE OF FLORIDA
COUNTY OF J 7, �(,I C-1 -e' COUNTY OF
The forgoing instrument Was acknowledged before me The forgoing instrument was acknowledged before me
this ZCAav of 204 by this day of 20_ by
Meu+ A 1torn
Name of person m=roduced
nt. Name of person making statement.
Personally Known Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
,(Signature of Notary P__ ic-State of Florida ) (Signature.of Notary Public-State of Florida)
Commission N 11p --CHRISTINE ' WELL Commission No. (Seal)
;'i�� �`�'; No Public-State of
My omm.Expires Au Florida21 2020
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