HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 1
Dater �. 1� 1� Permit Number:
RECEIVED
•
- Building Permit Application Nov 18 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: 0
PROPOSED IMPROVEMENT LOCATION: !fir
Address: Cnk to 1b :�) bcea
Property Tax ID#: Z)r 5__)0k _ 0090%_000_0% Lot No.
Site Plan Name: f Iln( l Block No.
Project Name: L)CAA I
DETAILED DESCRIPTION OF WORK:
ymmit mtjm, nr6 1 0 11
CONSTRUCTION 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:
/� n-6 Sq. Ft. of First Floor:
Cost of Construction:$ �I_)q (D t Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: 1
Address: 1 Ic Company: ( '
City: J State:'q Address: I( `
Zip Code: ?q�� Fax: City: ,y-� State
ppr
Phone No. Zip Code: ��- l Fax:
E-Mail: Phone No — 12 kq(A
Fill in fee simple Title Holder on next page (if different E-Mail ftokyl
from the Owner listed above) State or County Lic se V 7Cd3k, u
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.
if
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR-NOTICE OF OMMENCEMENT."
, .
Si att�ure f�ner Lessee/Contractor as Agent for Owner gnature ofd ractor/Licen older
STATE,¢F FLORIDA STATE gF FLORIDA ,
COU TY OF S� Ux_ COUNTY OF (°\e
The for oing instrument wa acknowledged before me The for oing instru ent warms ac�knyo/wledge before me
this ` day of (�uyP'n1 ,('Y 201q by this day of
Name of pers n making s atement. Name of pe on making statement.
Personally Known X _OR Produced Identification Personally Known OR Produced Identification
Type o 6n ification Type of Iden ' ' ation
Prod ed oduced
1�
/gnature of Notary Pu ( 'gnat re of Notary Public-State of Florida
2 ^ Notary Public State of Flori ammissionNo. t Lisa�l�harath os*� otaryPublicStateof to a
M Co i onFF9627 9 Commission No. : Bal(
My
Lisa Greer Sharath
OF aoQQ Expires 02/1812020 ? N` My Comrnisslon FF 46
N & Expires 021!S'^1 0
-V '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7119