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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: , �' u t � Permit Number: 05FY Building Permit Applic tion NOV 2 6 2019 Planning and Development Services Permitting DepIal tment Building and Code Regulation Division St. Lucie t,Ut1 �� 2300 Virginia Avenue,Fort Pierce FL 34982 y,. Phone: (772)462=1553 Fax: (772)462-1578 Commercial ReSIentla �- PERMITTYPE: c a : Address: L b-1 D Property Tax ID#: 2S7-!R' 5 � ( P LZ 000g Lot No. Site Plan Name: Block No. Project Name: 0 tf ©V S At t-3 Lu-'-s LN ST& c,._ N Additional work to be performed under this permit-check all that apply: —Mechanical —Gas Tank —Gas Piping —Shutters _Windows/Doors g p Electric Plumbing Sprinklers Generator Roof. Z cz -�°� Pitch — — — — Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: =Sewer —Septic Building Height: 4-2 S=E Name S y-p t I Name: 5'-oEVet j CABS-jG;,3Cst�tA�� _ Address: ? 6 5wc.. Al -l2 Company: 4RaaLc-C, City: State:_ Address: 3Z`11, Zip Code: 3'tot!&-j - Fax: City: State:Fc, Phone No. `L'Z` P»`Za Zip Code: '3LI c'i ?�. Fax: E-Mail: Phone No `1Z2-_ Zt,(. T 9-O �-7 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License L'CGOSS-S-z3 Got&g 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. SUPF'NOT, ENTA C•ONSTRUCTI©N LIEN INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: ��c �r�G�,,,, c� r�sc� Name: Address: Address: City: State: =—C— City: State: Zip: 3'-[imp Phone `i-Z2 q, to "7s`'I Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: , Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDAVIT: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 IMPRO ENT TO YOUR PROPERTY. A NOTICE OF COMMENCE laN�- T BE RECORDED AND POSTED ON TH JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INT"85-TO OBTA1 !!FINANCING, CONSULT WITH YOU DER OR ATTORNEY BEFORE RECORDING YOUR NO E F COMMENC'EMENT." Sign e e ee Contractor as Agent for Owner Signature of Contractor License o der STATE OF FLORIDb?- - STATE OF FLOR A COUNTY OF COUNTY OF The forgoing instrument pas acknowledged before me . The forgoing instrument was acknowledged before me this Lclay of dal 20� by thisday of��( i'y' 20 by �f7�7!ff X F ry IV of r) �'�ISTD 1\4 CS1/i�1 Name of person making statement. Name of person making statement. Personally Known LZ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature o o rk I'c- $ag,F _r'd A (Signature of NVary Pui�� � i AUDREY B.HUMPHREY A'vP( AU RE B.IJUMPHREY Commission No. '�� '"= MMISSIC�r� Mb 300817 °?* 9L"': ( 0517 Commission No. _ O�,gN41SSION i T om: EXPIRES:March 6,2023 EXPIRES:March 6,2023 a: :o; "'-.'e-- F- Thfu Notiry PublicUnderndtaM k REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED !;Fe—v-.