HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO tMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ]y�
Date: Permit Number: Vol
RECENED
_ w OCT 18 2019
Building Permit Application
Permitting Department
Planning and Development Services St.Lucie county
Building and Code Regulation Division
2300 Virginia Avenue;Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:. '
76 ►�✓oo FE�� C-
OPOSLD IM RO E�MENT O ATION•
Address: '-- z ��- �?� �T ��p�r�-��-T
Property Tax I D#: 2 , 'f[.j _ g:2 tO eO ! _ v P7 Lot No.
Site P1 an-Name: Block No.
Project Name:
DE AILED DExSCgPTION OF WOR
91, _ _
LU
CO STRUCTION NFO TION:
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:_ Coy �' �� - Sq. Ft. of First Floor:
Cost of Construction:$ J4<010Utilities: Sewer _Septic Building Height:
OWNER/LHE: /� CONTRA OR:
Name ---ff1'�R—���{���J,z�f���1-� Name:
Address:_47 C /ASAWWilT�,��,�D lZ Company:
City: A )-- �-�p/I e- State:7gL_ Address:
Zip Code: -,�[ a� Fax: City: State:
Phone No.. irk /�Q9 Zip Code: Fax:
E-Mail: D V_4A4A4.9E��� f 'Z (:goo Phone No
Fill-in fee simple Title Holder on next page(if different E-Ma.il
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.
SUP' LEMENTAL CON T' • • •
5 RUCTION LI N LAW INFORMATIO
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:COM _
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.
1.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, l 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 B FORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of 0;5�ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFA-l���({� COUNTY OF
The fo ing instrument as acknowledged before me The forgoing instrument was acknowledged before me
this day of 20A by this day of 20_ by
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 FL 0 Produced
(Signature of Notary Pubh State of Florida) (Signature of Notary Public-State of Florida
Commissio eal Commission No. (Seal)
ELLEN VA U G
s H N
�y
Commission #i GG 270 7
REVIEW �':? ONLY C= .2 bfkNTtxila 2ir 6 ERVISOR PLANS VEGETATION SEATURTLE MANGROVE
VIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19