HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST B�E�COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: kv ��• c� '1 Permit Number: O ��
fi g RECEIVED
Building Permit Applicatior NOV 14 2019
Planning and Development Services ST. Lucle County,.Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL'34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 1
PERMITTYPE: SNC
PRQPOSED tMPROUEMENT LOCAT ON:
Address: J 41-7
PropertyTaxlD#: 3L((4) - 5c.(0 -3 Lot No. S3
Site Plan Name: Block Block No."SZ!)
Project Name: ?-e=k1M9,LC4 �i�
DETAILED D�SCRfPTION tJF ORS :
1;�Lt L Q F.
` c�J c5 o O .A ON 13a.
c- Pr J606-
CONSTRU ION 1'N�FORMATION:
Additional work to be performed under this permit-check all that apply:
Mechanical ' _Gas Tank' it _Gas Piping _Shutters ; _Windows/Doors
_Electric _Plumbing, '=Sprinklers _Generator =Roof �Pitch,
e
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1z Utilities: _Sewer _Septic Building Height:
OWNER/LE-SSEE: CONTRAC OR:
Name TGN 9S S Name:
Address: (47 S ,,
City:F,6.9 Y State: C-1 Address:Sr S 6)
Zip CoCit
de: F ,:,, y. ' <yGi�. Statea�
1 ax:
171
Phone'.1\10•272, � •2-`'" =' 1� Zip Code: �g Fax:
E-Mail: Phone
Fill in fee simple Title Holder on next page(if different E-Mail lfd� Lc
from the Owner listed above)' State or County License 9
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 CONSTRUCTIQN LIEN LA INFORMATION:
DESIGNER/ENGINEER: . ' Not Applicable MORTGAGE COMPANY: Not Applicable
Name: - -. ..- . Name:
Address: ', Address:
City: State: City: State:
Zip: Phone, Zip: Phone:
FEESIMPLE 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,wo,rk 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."
Sig ature of Owner/Lessee/Contractor as Agent for Owner Signatur f Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF COUNTY OF
The fo oing instr m%ntwas acknowledge efore,me The fo oing instrunde Itaacknowledge efore me
his day of 2014by thisday of III V, 20 by
_c CUE
Name of person making statement. Name of person making statement. /
Personally Known OR Produced Identification P,/ Personally Known OR Produced Identification ✓
Type of Identific i n Type of Identifi . n
Produced Produced
(Signature of - af (Signature of a�ryP10,1, is w I LSEN
,_° °
KAREN S. NIELSEN O j',
��+YPoa, " :State of Florida-NotaryPublic
Commission N �O State of Florida(S&a4ry Public Commission N ._• •_ Commission #04IJ 7484
=* *= Commission # GG 207484OFFS° My Cornrnissloil Expires
My Commission Expires "�����"�� June 12, 2022
nine unesoft
REVIEWS FKUN I SUPE ISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW. REVIEW REVIEW .REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19