HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
JAIL ko 2020
__..r__.__ ._........._.__.__ Building Permit ApplicAft
Planning and Development Services St; Woe eoun nty
Building and Code Regulation Division
2.300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: AA 0 Nw""
�'AP
OOSED IIVIPR011EMENT LOCATION
Address: � �-�'8 5-e4vX i tn,0 1 e
Property Tax ID#: (21 — c9oy3- OUo--7 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF 1JUORK
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CON5TRUgtl'"N
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:$ ?i,000- Utilities: —Sewer _Septic Building Height:
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(31iVNE'R/LESSEE s .CCINT;RAC1tR
r., t
Name WicinSAeAe, Nl M�Jer5 Name:
Address: ' 49 lO[e U Company:
City: 5�)'± A.eyice- State: Address:
Zip Code: :!Aq9( Fax:_ _ City: State:
Phone Niio. I1Z) X11,�Co525 Zip Code: Fax:
E-Mail:,N IYlueKS 091�l) Phone No
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.
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�SUPPLEMENTAL'CONSTRUCTION L��iU 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
WIT U L NDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S� �aA Com_._ COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisy of �Q 40 ,20 0 by this_day of 20_ by
Nanp
Name of person making statement Name of person making statement.
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Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification.r Type of Identification
RProduced , D _ Produced
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(Signa of Notary Pu SEN VAUGHN (Signature of Notary Public-State of Florida)
Par
Commis ion No. rei,,�° a State f Florida Notary Public
_
Co # GG 270079 ommission No. (Seal)
Commission Expires
'� OF F•O�\` My
OCtob6r 22, 2022
REVIEWS FRONT ZONING. SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE'
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 21/7/19
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