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HomeMy WebLinkAboutBuilding Permit Application �•oa� � �5q All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �p Date: ' \ Permit Number: RECEIV5b _ Building Permit Application DEC 1 A 2019 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300.Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT TYPE: PROPOS�© IM�PROUEMENT OCATI©N: Address: olJr yycGC, <• for Rere-& 3 YS S� Property Tax lD#: 3 0 &lot ® ,�5j q q' ©M' � Lot No. Site Plan Name: Block No. Project Name: DETAILED )DEMSC«RI'Pf/TION W UVORK: ��i�/4 LZ ^Aa�,� 4��!�,! a.✓ �dL� '���4G�/ . J��y�yZ 7'c✓� ���C!' �''�}b use CO STIEMIO INFORMATION: Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank- _Gas Piping _Shutters _Wiridows/Doors Ia 19. 3112 Electric _Plumbing _Sprinklers _Generator —.116.9f, _-d l= Pitch . Total Sq. Ft of Construction: o94 Y Sq. Ft. of First Floor: Cost ofConstruction: $ o Utilities: _Sewer _Septic Building Height: OWNER/LEE, CONTRACTOR: Name L'sys Ce '7 Name: Address: 6-615 yvc t s >>;' Company: N City: State: Zip Code: Fax: City: State: Phone No. 17e'Z — FA � W 5'7 Zip Code:' � Fax: E-Mail: Phone"No`. ..,, ti -_ 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. P EMC � RU EWA,, L MA ON• 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 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 l 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 COMMENCEMENT." SignatlYre of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF � J�/� COUNTY OF The forgoing instr ment was acknowledged,before me The forgoing instrument was acknowledged before me this I day of 201_�Iby this day of 20_ by Name cf person ma ing statement. / Name of person making statement. Personally Known OR Produced Identification v Personally Known OR Produced Identification Type of Identifi n Type of Identification Produced Produced (Sig at re of NotZONTZOlq[N-G— eifr�lo ida (Signature of Notary Public-State of Florida ) KAREN $,. N ELSEN Commission No. of Florugltary Public Commission No. (Seal) mmission # GG 207484 y Commission Expires uneREVIEWS FERM OR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v.2/7/19