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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /2 -26 Permit Number: 9 i�.m-m &-i _ RECEIVE® Building Permit Application Planning and Development Services DEC 2 6 2019 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: 14 e C.aa C ' ROP©SEDcMR' OU MEN LOCATION. Address: l /� U�C0 CPVVI� CJ Y 1 e✓ a J Property Tax ID#: a4 2 J ' �.Q o 2,' ©G2 lI00- W Lot No. Site Plan Name: Block No. Project Name: DETAILED DE�SC`dPTlO OF WORK: 4k' n / t =-STRUIONINFORMA N: Additional work to be performed under this permit-check all that apply: VMechanical _Gas Tank _Gas Piping —Shutters _Windows/Doors Electric _Plumbing _-Sprinklers _Generator Roof'° Pit.ch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: _Sewer _Septic Building Height: OW ER/LE-�S�SE� : CONTRACTO'R: Name NO Name: ki e- Address: 1 11-7 OY 94e�Cp y� DV ' Company: City: -OY-." ". 1`2 ✓ i Stater Address: ` /1///,, @ 1!l 1V Zip Code: ac�S'C'l Fax.: City: - (.�-c Stater Phone No. '7'7 - 1 `j- /71.1. �� i,� Zip Code: 3-((-,7KFax: E-Mail: = Phone No '772 4 09 7O�4 Fill in fee simple Title Holder on next page(if different E-Mail 2CL-'t V'e_LIS a k oc2 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. S P'' L MENTA C«ONSTRUCUM LI 1 `• RMA CON. 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 =deed for any restrictions whichmay apply. In consideration of the granting of this requested permit, I do heret I will, in al[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 WJTU YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." (]�A Signature.of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI STATE OF FLORIDA COUNTY OF LUC I . COUNTY OF The rgoing instru ent was acknowledg before me The forgoing instru was acknowledge before me this day of 20M by this ent day of 20 by ' (moi Name of person making statement. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identifi Type of Identific Produced D Produced A 1� �(Ir i (Signature of Not - .ice (Signature ofLlablic-State of Florida) 1111,,, KAREN S. NIELSEN Commission o'PaY°`B%%State of Florida N ublic ,/ KAREN S. N1Rl� 5lffCommission N . d fjN commission #GG Z 484 Florida-N tary ublic*cCommission #My Commission Expires GG 207484 � MvII C^ June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS V ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.