HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / Permit Number: ' I
RECEIVED
Building Permit Applicatiop DEC 17 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 A—
PERMIT
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential TYPE: eynd.�I)n
Address: yy� 1,v/G�/�et l�_J� . Jt"P n/& , PG y9 3�7
Property Tax ID#: q,�5-0�-✓()) i`/_7o D 0 " 7 Lot No. I
Site Plan Name: :iyer/pf Block No.
Project Name:
Co /e.f rno /)14-H rye / !SD 5 . 0_ J e c P gNd
D/ roDrrt
Y) JVD �'r►q i',J
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: /D Sq. Ft. of First Floor: O 7
Cost of Construction: $ '►0 a Utilities: sewer _Septic Building Height:
Nam"6y a� �� 3G• �-�ere �✓�►! r�� Name: yn
Address: / n 5w -c JPI/tJ e vt7 Company: rr►� �A cAI v )iK,
City: S•L. State:�C. Address: 6/ ✓l z!�l. V2e4ee� IX G
Zip Code: Jq'K3 Fax: City: ,T�►s�n 'Je°*-Gh State:R.
Phone No. Z F9P'7_7 y1 Zip Code: Fax: 7,7)-,2-32—,21F1
E-Mail: Phone No /72`2 3 71
Fill in fee simple Title Holder on next page( if different E-Mail 4A i2l Srn/9%ne- y/q- C0• "t+q
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.
DESIGNER/ENGIN _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Phone:
FEE SIMPLE TITLE HOLDER: _ Not A BONDING COMPANY: Not Applicable
Name: me:
Address: 7AdrCity: / :
Zip: hone: Zip: ne:
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 LfNDER,6111AN ATTORNEY EFORE RECORDING YOUR N IC F COMMENCEME '
Signa ure of Owner/Lessee/ ractor as Agent for Owner Si ature of Contrac r/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF ffT±2 r,2 COUNTY OF �0171A/
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this / 7 day of !)E�G 20A by this /7 day of _W' 201q by
Name of person making statement.,( ! / Name of person making statement. /1 /
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced .11rl dt, Produced Fl ZU
6
(Sig u e o Notary� /tate ob) WtCWH�PHERD (Sig uX o N story,pu c )
R * MY COMMISSION#GG 052274 i°'"'•.�'� MISSION#GG 074
Commission No. N l �� EXPIRES:gfmmb3r4,2020 Commission Nt IRE&December 4, dal)
)`�,F FJoA Bonded Thru Budget Notary Services � �a
lFOF F%-G Bonded Ttw Budget Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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