HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1
Date: Permit Number:
"T If RECEIVED
Building Permit Application NOV ® 7 ")019
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
PERMIT TYPE: • l�\ n
PROI?.QSEDIItitIPRQ1/EMENT IaCATI,OIV „
Address: LA) 0 .SC�iI'?I c� Kl���� P"0/ b4 :R,eCC e - .F(- 2)(451
Property Tax ID#: 13bl _;_0a) Lot No. 9
Site Plan Name: Irf-k Ia+m &t'i)rfic4.y Im d-jn4i('C�5- - Block No.59 .
R '
" Project Name:
;DETAILED DESCRIPTION;Or 1NORK"
CQNSTRUCTIQN.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 Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2 CC(Y`7 Utilities: —Sewer —Septic Building Height:
"C7WNERjCESaEE CaNTRACTOR`
Name H1C ' (,tj hf1J1 Name: ffroy, (&n)
,n ', l.,l.
Address: i7C.jI c) fmon- ay,� ryiY Company: 5 1 n
City: Ch int State: Address: _ I
Zip Code: ?(��(� Fax: City: I �7''j �ic'�(1 l� Stater-
Phone No.73U_3 hlD 21'5 Zip Code: '�, ";Ut-�.a Fax:
c ^-
E-Mail: Phone No
6&.-809%-{r733.ei .
Fill in fee simple Title Holder on next page(if different E-MailT'fY�{�C1�1�I�Y��C�iU�S��LfjC�Ct
from the Owner listed above) State or County License FI CV UA•'C kCQLiLeCA
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 CONSTRUCT,104I.IEN,LAW IN -ORMATtC}N.
�..�.
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
WffH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA _ y STATE OF FLORIDA ,
. , COUNTY OF f>i�(-jt? C�2c COUNTY OF Van
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The fo going instrucknowledgefore me The foydoing instru Grp vyay'acknowledged ore me
this day of (•f 20rbi this (qday of 20 y,
Name of person making statement. Name of person making state ent.
Personally Known --- OR'Produced Identification X// Personally Known 1/ OR Produced Identification
Type of Identificati �1 J Type of Identification
0
Produced,,--- z" '" Produced
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(Signature o ry'Public- a= ` iridCommissio GG 178187 (S'g� nat rr''e=' Nofary Public-State of Flofiop
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Commission No. �� 4.a (� �� g u
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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