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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��, Permit Number: a??70 0.RECEIVED Aft- ' JAN 17 2020 Building Permipp icat on Planning and Development Services Permitting ®epartme Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 y, Phone:-(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: T11A✓V-� 6 PROPOSED 1'MPR01/EMENT LOCATIO Address: 5, U Hict:!DYL1 '. . , .��2YCe, �i . �87 Property Tax ID#: J40�.- uocc- Lot No. ` Site Plan Name: _ ryii lzY &S4i�eS Block No. Project Name: DETA11LED ON OF WORK: - pV QC e_K66�i(te, '1 u+m► G 'An h,cnrr-(-- +0 C)v rVM-1 C Qc�L '�. �►Lo exi �� mU►S�er 1na-�rc�m S1-,�v,,ef'. CONSTRUCTION INEORMA tON 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:$ L4)OCC °cam Utilities: _Sewer _Septic Building Height: OWN NROMI&SSEE: CONTRACTOR: Name6'rkC__k vY> Name: cw er Address: to Reh -Oru __k__')C. Corripany 1 cls' City:V�.7"te—Yrr_ State:. Addres�.f Zip Code: !Ag237 Fax: City l "` State: PhoneN : . -._., aC��'2.. mel ��' Zip Code. .Fax: E-Mail: i 1 e Phone No Fill in fee simple Tit a Holder on next page(if different E-Mail from the Owner listed above) State or County License e.-`4' 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 r 1FegGired, SUFPL�'MENTAL CONSTRUCTI©N LIE LAW IN �ORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address:_ Address: WA 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 thepermit 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 IMPROYEMENTS 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-A-ITORNEY BEFORE-RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA - STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instr�wTent was acknowledged before me The forgoing instrument was acknowledged before me this_M day of /� 2QX-by this day of 20_ by Y` i Cz re-29 hGL I-n Name of person making statement. Name of person making statement. Personally Known 1// OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Not (Signature of Notary Public-State of Florida} AIlDRc^(B.-qumpH Commission No. :�; ;t: MYcOMMIS�I 1 G0300817 Commission No. (Seal) EXPIRES: 6,2023 .jrF doe. 6: ::d Thm ri0wy P11bIIC ll1&nP1i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. ZI 19 I I