HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ` ` z Permit Number:
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p 62ECEIVED
Building Permit Application JAN 0 7 2020
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
PERMITTYPE:
PR(JPE2SED IMP101/EMENT LOC;4TI�N.
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Address:
Property Tax ID#: 3�2 o Z ' Q 2 ?j - - D Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRlPTtC?N OFA WORK r41
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CONSTRlJCTION INFC7RMAT10N ; yy ,, � � #e r � ,�� ,
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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: Sq. Ft.of First Floor:
Cost of Construction:$ 3,400 Utilities: _Sewer _Septic Building Height:
01A/NER/LESS EE Y CONTRACTOR
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Name Gv1 W i Y1 C Name: D des rh(I I c
Address: 1 S COW) 'r-/ R QOVEO �� Company: -n,</l W (f0(0 ll 0 11�C
City: State:� Address: /S*/ St 86-(CO(/r C7—
Zip Code: 120 7 S` Fax: City: 1) e,L State:
Phone No. ZZ Z g !' Z �3 t`J Zip Code: 34y.S Z Fax:
E-Mail: Phone No -7Z 2 q 0 V73 J
Fill in fee simple Title Holder on next page(if different E-Mail 1, y 10)0(90 I�)c_y b'g"h(go - CO�
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.
SUPPLEMENTAL C0(VSTRl1CT ON Ll LAIN 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 COMMENCEMENT."
Si at re of Owner/Lessee/Contractor as Agent or Owner i re of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S�% LJ�c � COUNTY OF 's-V, L ur e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of iSw r\ 20 Re by this —A' day of arm 2A) by
Name of person making sta a ent. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced C) Produced L >D L
~a
(Signature of Notary ublic- Torida)DEANNA 0220'3 Si nature of Nota �1 -'•�;dte r ' 2 Ji
MY COM44ISSlON#GG ( , IW# t1dl4I�N#GG 0:''1'.3
=2°�~ �u3 DecembeP 16,202 o EXPIRES:Derember 1"0,2U,u '
:xz PIRES: do ricers l', ">� is Ut; F
Commission No.Cr�sd��a :; (Se NNo�,�pubtiaun mission No. aL�ondedThmNctl�
"-•,9'F�,�,oe`; BondBdTh Mi
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
R—ev-7277/19