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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j� Date:2A.W Permit Number: 2W�- 2J4.(,9 1 RECEM ! Building Permit Applicatin MAR 0 9 2020 Planning and Development Services ST. Lucie County, Permits: r Building and Code Regulation Division 2300 Virginia Avenue,Fort'Pierce FL 34982 " Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PR�POSED lMP OVEM�E T LO A ION: Address: '5;3 (- Qu fCJ*"d 14ke C 1 f Property Tax ID#: le, ` e)Z — ' ID Lot No. _ Site Plan Name: /I�� Block No. Project Name: PC,I<fY re-h e D A{LED DE�SCR{P ION OF WOR a ' �1 qIn IiV�rll� t/.r�1 LSI /Cr r� C•Z i1✓���l�i r (iG7L'S' CONSTR CT(ON INFORM TON: Additional work to be performed , under this permit-check all that apply: CC _Mechanical _Gas Tan•k'- _Gas Piping _Shutters —Windows/Doors Electric _`Plumbing. t ;- 'Spfinklers _Generator t 'Roof - Fitch' Total �t of Construction: 7 Sq. Ft. of First Floor: Cost of Construction:$ 2,•`?'j `— Utilities: _Sewer —Septic Building Height: N'E�R/LES-�E : C• NTRACTOR: Name 49e. 111'cl"6? i illile�- Name: �c,y�r �Ge' Gi•�1.C.i1(� J©EU�.`(L�" Address: C7 ��-b [�lr.k t,el [o(ce- _ civ: Company: = <1 AA c� City: %eek State:F4 Address: Zip Code: Fax:' City: u&�2 BrutesC " State: Phone No. S`J C C/-` y Zip Code: :.lZ 'Z Fax: E-Mail: Phone No 77� `�s(-' -��7 G� Fill in fee simple Title Holder on next page(if different E-Mail 1' i 4exrc/ leen c.'v+n 541't f,` kl 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. 'UPPLEMRN ALC@NST :tY!COITIII WWII W I'NFCIRMATIO DESIGNER/ENGINEER: _Not ApplicableMORTGAGE 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 0WNER: 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 COMME Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF t . IE , COUNTY OF The f going instr ent wa acknowledged before me The f oing instr e t wa acknowledged before me this�day of 207j by this day of 20M by L�a Aen Name of person making statement. Name of person making statement. Personally Known OR Produced Identification V/ Personally Known OR Produced Identification Type of Identific tion Type of Identification Produced Produced (Signatur D (Sign - �1%1yy ��, KAREN S. NIELSEN ,+,,,, "Y'G KAREN S..NIELSEf� Commissi P B�;State of Florida-Not@g��j blic Com „ vP���' _* *= ommission # GG 207484 _ Stat of of Florida-Notary P ) Commission # GG 207484 ?9,fo `oQ�c My Commission Expires b P Mv Commission Expires rre ++++` Un 12, 2022 REVIEW MINT ZONING SUPERVISOR PLA MANGROVE COUNTER REVIEW "REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.