HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Al lPermit Number:
RECEIVED
' DEC 13 ?919
--- P Building Permit Application
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 Residential
PERMITTYPE: t64 c- e-o
PROPOSED IMPROVEMENT LOCATION:
Address: 24.1) l I0SSoM ( 0y-"2-
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Tovs 6,,39m&,
CONSTRUCTION INFORMATION:
Add itional'work to be performed under this permit-check all that apply:
4/Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft dfConstruction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name T� Name: w i, - Qora*4U` _-,
C-
'
Address: �����1�/ anri l he Cd V0 Company: 12i� y
City: IST,,/ �-� L &J' Stater Address: b-�t� S+a /g24,7O
r
Zip Code: d /Fax: City: -P/A/11 ynl�(' [,� State:(,
Phone No. T 2 7--7)7 �1 7 �i Zip Code: T Qq _ Fax:
E-Mail: Phone No -)-337121
Fill in fee simple Title Holder on next page(if different E=Mail 2YL DOv r�
from the Owner listed above) State or County License Of C
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.
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."
Signature of Owner/LesseOCbntractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO IDA STATE OF FLORIDA
COUNTY OF aP, W t`\"k COUNTY OF 5-3r• L Jc,�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day of Qom_ .20 77_ by this�"bo day of �Q r_ ,20A by
�c
Name of person making statement.' Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identif ation Type of Identification
Produced L L Produced °F L L
MIRROR G..
(Signature of Notary Public-State of Florida) (Signature of N '' -S AI(ihI99idiQJGG 022023 I
Oa :; EXPIRES:December 16,2020
Commission No. pEANNANIARIEGNEN Co JYmission No F dThruNotary l�6JtW)derwrirers
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COMIAI ION#GG 02 023
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REVIEWS FRONT99t1 S VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7119