HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �'S C� a Permit Nuot "c- 1! PEW
' 1 I V t a.
FEB 5 2020
w Building Permit App 'FRl Il hng 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 k
PERMITTYPE: 40
PRO OSE[) MPRO E�MENT LOCATION:
Address: & e- t. Lf f'G- 3 4 2
Property Tax ID#: 3q a .(roc'• o3% (90oL Lot No.
Site Plan Name: Block No.
Project Name:
QETAILED DE�5CRlPTION Cr7F WOR+K:
/ cr
14,11.sm 111-111111IO1111111 M TfiON:
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:$ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: L✓ L
Address: Company: 4 l i-
r1CLDFf�,IIC
City: f-E. �r`eC�iP State: Address: ( i v
Zip Code: 3yf cj Fax: City: r - -i State: rt_
Phone No. Z 77-97`y3�2 . Zip Code: Fax:
E-Mail: Phone NofjjZ Q71273 (
,
Fill in fee simple Title Holder on next page(if different E=Mail KD t hen u h «, [N I t i X hya. tar,
from the Owner listed above) State or County License n-1 7�
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.
NINNY,MENTAL CONSTRUCTION LI N WIN �URMAmems.
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 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 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 WNDER OR,4 ATTORNEY BEFORE RECORDING YOUR NOTICEa COMMENC T."
Signa re of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA C
COUNTY OFCOUNTY OF
The forgoing instrument was acknowledgEK before me Thefo oing instrument was acknowledged before me
this_day of �Q b 20' by this9 day of 2&�O by
rk; 1L& y L�K_KQ"_ l�o c1 "
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identificati� Personally Known OR Produced Identification'
Type of Identification Type of Identification
Produced Produced
ig ature of Notary PubI4 State of Florida)v I n ture of Notary Public tate of Florida)
Commission No. (Seal) Commission No. (Seal)
f-FYYR2+@nLT.�
INGRAM-RAHMING11
CONII AISSION#GG 27506 '—
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DATE F�{f;°' Bot ded Thru Notary Public U erwriters
RECEIVED rz;.
DATE
COMPLETED
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