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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l Permit Num e`,=vFMM � - NOV 262019 Building Permit Appl 04-099ting Department Planning and Development Services St. LLlCie Count Y,and Code Regulation Division • yr FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: �C*?P©, D MPftOUEMENT OC TION.. Address: I0_2 0-3 'P-D IFI REFY `tom Property Tax ID#:_ 23 Z4S 5_0 l onc-2- oc�S- Lot No. Site Plan Name: Block No. Project Name: � lLED DE�SG �IPTION � WORK: SULUC—L4; E Lit- SCAV k_ W 6'-u0 L Sy GLL I.zuL7��2 CR.1ww c A,3-J`9 `. " S[l,V.i 6 5 Wl L=TA\i, salt 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 fZ Pitch Total Sq. Ft of Construction: 12G0 Sq. Ft.of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: ( 5_vz� OWN R/LE�S�SEE: iONTRACTIJ .Name sz�f E ,T Stcc,.,n��,rr_ Name: Address: ?b 10&Y_ t i.'t7 Company: City: V�7-c PD--m' State:�E. Address: 3z--1 L Zip Code: 14A 9-1 Fax: City: VU Staters Phone No. �l LZ x 2,q 0-1 Zip Code: Fax: E-Mail: Phone No 2,L69 —�r'4 --7 Fill in fee simple Title Holder on next page ( if different E-Mail 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. UPPL M NTAL C©NSTRt�CTfON L ESN LAW !NF© iUTATlON: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: /kn� ,oTG ., c, q=-� C' Name: Address: -rc LAruA& — Address: City: el e4,e- Stater City: State: Zip: 3_c� Phone 1-1Z y/O '77!5F I Zip: Phone: 0 -7 7 S-1 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 IMPROVEM!!,EN YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON HE JpffSITEBEFORE THE FIRST INSPECTION. IF YOU INTEND T AIN F1194NCING, CONSULT WITH YOU NQLIR OR 0ATTORNEY BEFORE RECORDING YOUR NOTIC COMMENCEME ." Signature of Owner ee Contractor as Agent for Owner Signature of Contras or -cense Holder STATE OF FLORID � STATE OF FLORI COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrumentwasacknowledged before me thisday of 201q,by this day of ``I/ ` 20 P9 by S��yfn Name of person making statement. Name of person making statement. Personally Known - OR Produced Identification Personally Known `/ OR Produced Identification Type of Identification Type of Identification Produced Produced &&Z 9 Z (Signature of N&tAry Public-State of Florida ) (Signature of N`ot rCYa a nfj " ;otr�ye�B�.: AUDREY B.HUMPHREY Commission No. "N7 AUDRE AMPHREY Commission N ISSION#kC{lSE 17 1 c_ MY COMMISSION#GG 300817 - *: p�� ao= EXPIRES:March 6,2023 a e-` Public Underr;rters U Bonded Thru Notary P blic Undenvriter� `— REVIEWS F « "�TPEN1-146R PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.