HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: FeAluct Permit Number: aaoa-bro�3
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- Building Permit ApplicatiPlanning and Development ServicesBuilding and Code Regulation Division rmitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _
PERMITTYPE:
PROPOSE D.IM PROVE MENT,LOCATION':
Address: 5g16 Shcknflok -Drille r-aa-4- Piece, A- 30SI
Property Tax ID#: X01 - ( 3- 0105- Coo - 67 Lot No. ;-) I
Site Plan Name: N(A Block No. 140
Project Name: Labe utc)J Pdr k - U ml I f - L3 l k ILI0 - Lor- 021
DETAI.LED.DESCRLPTION QF WORK ,.
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C'Yocce'-d -ep-s
CO NST RUCTION:INFORMATLON:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric o
Plumbing _S rinklers _Generator Roof m Pitch
Total Sq. Ft of Construction: oC,ID Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height: _
OWNER/LESSEE' .CONTRACTOR
Name h A 0 1,dpr Name: C
Address: �� S Shan nOh l�r<<lo- Company: i A/1wel
City: ea rc e State:�L Address: /�3 a _ ,c RSA/�;:ao' k
Zip Code: �( Fax: City: art State:
Phone No. i90 r7 Zip Code: � '-3 997 Fax:
E-Mail: Phone No 772 . a 35/- �603y
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Ap cable MORTGAGE COMPANY: _Not pplicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLD : _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/6ONTRACTOR 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."
P �
ignature of O er/Lessee/Contractor as Agent for Owner Slg ature of ontractor License Holder
STATE OF FLORIDA STATE OF FLOR�DA��c
COUNTY OF L(L t/ COUNTY OF
The for,�ing instrument was acknowledged before me The forgoing instrument was acknowledges before me
thi9�.5—day of 20 020 by this Co day of'C,�.)o .20a by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification X Personally Known OR Produced Identification
Type of Identification _q
a Type of Identification
Produced l i'O " � C17 b d " (/Vk_0 Produced 1. L
F/woon Inver5 LleelSe
(Signature of Notary Public-State of Florida (Signature of Nota[.,., �Jictugg
ADIANNEMcKUHEN ' P - DEANNA RIE GIVEN
Commission No. r— Commission NO. amCOmmissi (0SV§� SSION#FF998795 20
23
�doFr E)cPIRES:July 21,2020 -EXPIRES:December 16,2020
Bonded Thm Notary Public Underwriters
szas�rnzr:,�:.�. ovcr®
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
::Fe—v-.2/7/19