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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED o Date: Permit Numbe.: P=_' pp= 61" IV NEI • JAN 9 2020 Building Permit Applic WNitting Department Planning and Development Services Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: V ME PA PO o ' fl'QN SEb,_'l_M0RO 0 NT'�L CA Address: V Property Tax lD#: 0,3 '0 00- 9 Lot No. Site Plan Name: Block No. Project Name: V DETAILEDDESCRIPTIOW0 F WORK K A44(24'e- Aoaz�f� 4214.1— 4- Ll CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: —Mechanical —Gas Tank Gas Piping Shutters Windows/Doors XElectric —Plumbing Sprinklers Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ &-56. 00 Utilities: —Sewer Septic Building Height: _ OWN ERAESSEE:, _CONTRACTOR.' �, Name Name: Address: Company: =AZ4:1�� JALW;Cd.0_) Address: -P�t..r tJ State:_4L Address: 81.9 a Zip Code: .3AI 9.51 — Fax: City: /442"X,—) -State:Phone No. Szoa. 30Q- 0..3a, Zip Code: 34 9AA5' Fax: A14/-.Q2,78 E-Mail: Phone No 4(6,J- .2 7-2-7 Fill in fee simple Title Holder on next page if different E-Mail 1)7ilef- &-04�- from the Owner listed above) State or County License Edi. 1300 -�59S 9 SLe- Rqg'7S 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- DESIGNER/ENGINEER: Not Applicable t MORTGAGE COMPANY: VNot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: �e 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 COMMENCEMENUST BE RECORDED AND POSTED ON THE JOB EFORE THE FIRST INSPECTION. IF YOU INTEND TO T IN FINANCING, CONSULT WITH OUR LE AN ATTORNEY BEFORE RECORDING YO OFC AME EMENT." c Airt&Fewner/L e/Contractor as Agent for Owner Sign ure of Contra ctorAkense Holder STATE OF FLORIQA r STATE OF FLORID COUNTY OFA J_I JC Qt COUNTY OF- J 'UU& The forgoing instr Lvaent was acknowledged before me The for�oing instr�nt was acknowledged before me this day of P��✓ 20�2o by this�day of^�(rti�`�'1 ,20_ZO by �CW Qolk CW Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known 1// OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public-kate of Florida) (Signature of Notary Public-State of Florida) ""yDavid Raymond Prue David Raymon Commission No. C�Q01-F7©V_ NOTARY PUB IQommission No. C, �, -70SoZ. NOTARYPUB STATE OF FL RIDA STATE OF FL DA i Comrtt Comtr*GG28 • SCE 19 Expires 1/26,2023 Expires 1 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.