HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Permit Number: "zD I �II
1
RECEIVED
Building Permit Application 7AN 1 7 2020 ;I
Planning and Development Services permitting Department
St. Lucie county
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: - O
Address: LI a Fo c i _ .1 e f C Q- FL
Property Tax ID#: oc Q 'f ' l�c� - c a o y ' O OO Lot No.
Site Plan Name: U.� 1 d i.� Block No.
Project Name:
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1�er� y anlu. - .ow � �a� W�1�s Inieoio
lox to R re o�_
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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
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Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ p C7 Utilities: _Sewer _Septic Building Height:
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NameC 10 bcd l _6 11ecc flial Name: 7NO 110 73,o.Co bE
Address: y OS I,� - S T7 W�x I Company: _JOV n SG.Cc bS Cpn_Wuc-4'Jon
City: �'o rl�p')uCP_ State: V,L Address: Qo r�e( Q e
Zip Code: '3q990 Fax: City: 1 0 r� (Fi e-5 c E State: IF
Phone No. Zip Code: 3 49 91 Fax:
E-Mail: Phone No -77a S cQ - S 3 3 y
Fill in fee simple Title Holder on next page(if different E-Mail r r'i Cc bs y 70 ( G-1 q r)"� CO
from the Owner listed above) State or County License C B C 6 6 y Z 1
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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DESIGNERjENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: M Name:
Address: Address: I
City: State: City: State:
Zip: Phone Zip: Phone: I
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: I
City: City: C
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. I
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 RECORDU D 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." i
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Signa re of Owner) a see/Contra oras gent for Owner Signature Contractor/ i ense Holder
STA OF FLORIDA STATE FLORIDA
COUNTY OF �}, L(a„ c i 'Q- COUNTY OF Si u
The forgRing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �g nUpr,CIF— 20 ZO by this day of
77�' 77 a r 20 ZO by
7n1Nn -:50'co b _J5%nr' -:S.co b-S'
Name of person making statement. Name of person making statement.
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Personally Known��OR Produced Identi ' Personally Known OR Produced Identification .
Type of Identification Type of Identification
Produced §� Produced
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(Signature otWotary Public-State of Fl a) 0 (Signature of Qtary Public-State of Flormilw
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Commission No. ' ( ) �.O 6 990 Seal N�'�Q Commission No. G °)d (0 8 g4 (Seal)
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REVIEWS FRONT ZONING SU R R PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW RVI REVIEW REVIEW REVIEW REVIEW
DATE
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