HomeMy WebLinkAboutBuilding Permit Application L099f_.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Q
Date: ,� �� n- Permit Number:
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Building Permit Application 2 6 2019
Planning and Development Services � ST. Lucie County, Per fling.
VEII
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)-462-1578 Commercial Residential
PERMITTYPE:
PROPOSED IM9ROUEMENI LOCATION:
Address:- --- - -- -�- - ---- - .-� -- - - - - - ----- --- ---- - - -
Property Tax ID#: '3 C5 (`� l �-� (9'� ®' r Lot No.
Site Plan Name: d Block No.
Project Name: 2e9 kl C*, -
DE ACLED DE�SCR++tPTtON OE WORK:
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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: t(& -eQ Sq. Ft. of First Floor: -
Cost of Construction:$ Utilities. =Sewer _Septic Building Height.
OWNER/LESSEE: CONTRA TOR:
Name Name:
Address: CS Company:
City: State:. Address". .................:«... = -
Zip Code: �,�( ( Fax: City: State:
Phone No. - �-d- 6 P4 Zip Coder Fax:i
E-Mail: u,"I 5 VA roC.g, a(? Phone.No -.- -
Fill in fee simple Title Holder on next page(if AerenfMail
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.
SIJPPLEMENTA CONSTRUC i0N LIEN tAW t'NFORMATttJN:
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 nQn-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 Owner/Lessee/Contractor as A t for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF . �. )C',�� COUNTY OF
The forgoing instrum nt was acknowledg before me The forgoing instrument was acknowledged before me
thisZday of 20LI by this day of 20_ by
Name of person making statement. / Name of person making statement.
__ _Personally Known OR Produced Identification V Personally Known OR Produced Identification
Type of Ident' ' ation -Type of Identification - _ --
Produced Produced
A A �A,
(Signature o otary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. REN S SRRLkLSEN Commission No. (Seal)
State of Florida-Notary Public
Commission # GG 207484
prF y Commission Expires it
2, 20
REVIEWS OR PLANS VEGETATION SEA TURTLE MANGROVE
'MUMTER REVIEW 'REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19