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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^ Date: 1� '( Permit Number. RECEIVED s. Building Permit Application JAN 13 2019 Planning and Development Services BT. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 �. t Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: V PROP©SED d'MPR01/EMfNT LOCATIC/N' Address: SDO� },� iGGC.0N Dr. :F0 rt E2rcC_ 34g82 Property Tax ID#: q0 2, LR 0�A 2s- (F'��•Ln Lot No. Site Plan Name: Block No. Project Name: DETAILED DESC«RIPTION ©E WORK: CtJNSTROOM ION I INFORMATION: Additional work to be performed under this permit-.check all that apply: Mechanical Gas Tank'` ' _Gas'Piping-- _Shutters- _Windows/Doors Elecf�ic -Plumbing_: -`" �, .Sprinklers _Generator , .; _Roof +. -Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: OWNER/'1LESSEE: 1 CONTRACTOR: Name L'�WY CQ'. I �a►n Name: nI- 'cL0" V-0 e- ,l Ca ►72'Yrn Address: 51�10 4- J kt c1G0NN i�)Y , Company O.U-L.o.S...._` �STrt9C1'i0� C City: DState'; R_ Address: 2jgi5 - 11.E .� g Zip Code: city: a .,`pf��CQ State: Phone No. 7Zip Co 8) Fax: E-Mail: Phone No ^78< Zd Fill in fee simple Title Holder on next page (if different E-Mail Acu LoScovic,+r'. j li G w a,{ . co vA from the Owner listed above) State or County License r-.Or/G(G , CQC1.5 5- If 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. Awmw&1mmff&um.um LAW 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 ap'plicable,Hom.e Owners Association rules, bylaws,or and covenants that:may restrict or prohibit such m structure. Please consult with your Hoe 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 R OR AN ATTORNEY BEFORE RECORDING'YOUR NOTIC CO ENCEMENT."' ' Signature of Own e Lessee/Contractor as Agent for Owner Signature of Contract /License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Lt)C�,IF, COUNTY'OF The f going instru ent was acknowledged before me The f oing Instru� ent was acknowledged efore me this day of 2&0 by this day of MISA2by I�YJ Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific rt10 Type of Identific,} Produced Produced r (� (Signature o (Signature of Notary Public-'State-bf�Flor.'ida)` KAREN S. -SEN., tear e'%., , Commission oi° ,State of'Fld`rida= �i� Fublic Comm sioO�drJ�}, KQRFN n;IELSEI�e. ommissio:n #.. G 2074841:: ;`.PpY°bB' � � State of Florida-Notary Publio �9j'FOF FIOP� P✓ly Commission Commission # GG 207484 P - MYCom ,ission Expires OF f\O REVIEWS FRONT ZONING Y, SUPERVISOR PLAN VKPTATinrjun MANGROVE COUNTER, REVIEW, . REVIEW REVIE REVIEW DATE RECI=IVEIJ-, DATE COMPLETED ev. 2/7/19