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HomeMy WebLinkAboutBuidling Permit All APPLICABL INFO MUF BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q �} Date: Permit Number: I 1 17 REC�rv�a _ DEC 0 3 2019 Building Permit Applicat on Planning and Development Services ST. Lucie County,.Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 - Phone: (772)462-1553 Fax: (772)462-1578 Commercial Kesidential PERMIT TYPE: . PROPOSED IM(PROVEMENt.LOCATION Address: © �D - Property Tax ID#: 1 3� - �f ('�!� —©�'�(��� Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION;OF WORK ; QX r n n QAa reeloce Z -1 - 2-1 CO'NSTRIJCTION INFORMATION: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _/Windows/D ors Electric _Plumbing _Sprinklers _Generator _Roof � � Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: LO ;01NNER/LESSEE CONTRACTOR: Name QL. Name: p 1 Address: )4b a Q CY Company 'C n ill f City: State: 4fC Addres ��°` Zip Code:";gC( S Fax: City: Q State Phone No. Zip Code:,._ &gU c_�— Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail f ,C from the Owner listed above) State or County License_ 0 o � R C)a- 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. SU,PPLEME,NTAL-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 IMPROYEMENTS 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 LE DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ignature of Owner/Lessee/ ractor as Agent for Owner i/ ature of Contractor/License Holder STATE OF FLORID STATE OF FLO A � COUNTY 0 � (-�__ COUNTY The fXgoi g in ent was acknowledgVby efore me The f rgoi g in Went was acknowledge before me ay of 2Q ay of i/ 20 by (A �>�t 1 All9)1&Ad Name of person making statement. Name of person making statement. Personally Known — OR Produced Identifica Personally Known OR Produced Identification Type of Identification ".o N Type of Identification Produced Produced .� U my N_ np-J (Signature of Notarypublic-State`off Florida) �,� (Signature of Notary Public-State of Commission No. �) `� 3eal) .,f oa Commission NmEa oG� ) v ? REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAT RT E� A_ ROVE. COUNTER REVIEW REVIEW REVIEW REVIEW REV R IEW.,.. DATE RECEIVED °"•�' _ DATE COMPLETED Rev.21/7/19