HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .
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Date: o� Permit N r -
• - FEB 2020
- - - Building Permit.AprilN .
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Planning and Development Services
d ml.Lt nq Department
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
PERMIT TYPE: <' eC C --
PROPOSED IMPROVEMENT`LOCATION: °
Address: 2.91.3. . C d(N i C r: p �-
Property Tax ID#: �12 7 ' "RO: 1 - 0-7 b - : 060 — Lot.No.,
Site Plan Name: " Block No.
Project Name:
DETAILED DESCRIPTION OF.WORK
Vo1�_ ri"(`cel
3 S1�u9 keys n 6u uc ��''0 )
CONSTRUCTION INFORMATION:
Additional work to.be performed under this permit-check all that apply:
^fMechanical _Gas Tank „. _Gas Piping _Shutters _Windows/Doors
1 Electric Plumbing _Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: sq. Ft.of First Floor:
Cost of Construction:$ S I g, Q o Utilities: Sewer _Se ptic Building Height:
OWNER/LESSEE:- k CONTRACTOR:
Name`.. Y'N v(I ......... .. ..: . Name.." `'�(`ILC�Uf`n G "."...•.;t. ;
Address: 2 D 1 (7 L,D.' f�C l rN U 1� _ o Company: Vu� :Z
City: C� 4,'_t)UCAL State: 0 Address: 3 S o q - Olde ,
Zip Code: '1 L 0 Fax: - City: O f'4- .:
rCe' State: l--L
Phone No. 3 - -7 q 4- 6.S S Zip Code: �Lt 4(f 7 Fax: 1.7-Z --W6-U90
E-Mail: . S Uco la . dU4-(60k ,COM Phone No �2 - .�1.� . OSad ..
Fill-in fee simple Title Holder on next page(if different E-Mail In(- (9 0\0 l Conk
from the Owner listed above) State or County License (, I d a SS 17
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIONS
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: T 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 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 L15NDER OR AN ATTORNEY BEFORE RECORDING YOUR N TICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Co tractor as Agent for Owner Signature of Contractor/L' ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF U4"y COUNTY OF Sly-rLuckc
The forgoing instru�n was acknowledged before me The forgoing instrume t was acknowledged before me
this_1:7 day of 20-z-0 by this l_J_day of rf, rUu 20?4 by
N L L-Q40 J PIK
Name of person making statement. Name of person making statement.
Personally KnownOR Produced Identification Personally Known N OR Produced Identification
Type of Identification _ Type of Identification
Produced Produced
� s
Notary Public State of Florida Notary Public State of Florida
(Signature of No lig- 165685 (Signature of Not ir~;S
St �S r ��185665
Expires 02/26/2022 �a Expires 02/26/2022
Commission No. Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW ..
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19