HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�
Date: Oao Permit Number: (.00a-ow
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Building Permit Application FEB f2 2020
Planning and Development Services Permitting Dlpartrnent
Building and Code Regulation Division St Lucie Count
y
2300 Virginia Avenue, Fort Pierce FL 34982 ✓
Phone: (772) 462-1553 Fax: (772) 462-1578 COr1' merCial Residential
PERMITTYPE: �Re_oIQcp WrAJe,r heakf—
'Address: 14(o Ru-s5e- LL l (i ii-o A'eru f R. 34_ 9 u-
P ro pe rty Tax ID #: �o�l4,)-$' - '7Di ^ "UOL-,)9 - 000 I5 Lot No.�
Site Plan Name: _(f1 UQ S /D 'C/UD 1i 0 it 43 J 7°t. O FT 6PIW I? Block No.
Project Name:
I=
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``:
Cost of Construction: $ 1fz)0 . D D
Sq. Ft. of First Floor:
Utilities: —Sewer .—Septic
Building Height:
t3 ER/LESSE
f�NTRAC C3
Name 1
Name:
Address: 140
Company:
City: -(-GP State: (•,1
Zip Code: a (40 9D- Fax:
Phone No. "1-1*,), • S- os-1
-Address: "
;City:. = State:
!'Zip Code: ... -'Fax:
Phone No
/1 "
E-Mail:_ �0.t1c�r� ne_ISsY1 03 &,i&J S6-xA' OC
Fill in fee -simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
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.
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGAGE COM ANY: _ Not Applicable
Name: tLL
Address: D55QQ CQMMCrC0__Q�—e
City: I0Ii Eor'c_S^, 94- State: A -
Zip: CIJlo?0 Phone: 52M - 332 . G 88R
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signa ure of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The f going instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of ` 20 by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Sin re of Notary Public- of Florida)J
(Signature of Notary Public- State of Florida )
"�rPU'6-_( flMMINGRAS.-
Commission No. RAHMI
*= OMMISSION
o mission No. (Seal)
G
# GG 275
EXPIRES: December 20
60
wncfW
ni Notary Public Under
titers
REVIEWS
FRONT
ZONING
NS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19