HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE
INFO MUST'BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11�
Date: Permit Number:
RECEIVED ,
,_
M � FEB 181020
Building Permit Applicatioraermitting DePartment
St. Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
P RO POS E D'1I M P ROV E M ENT. LOCATION:
Address: 10 '1 O Z S CT`OCV�'-DY . `�0- 1
PropertyTax ID #: USUZ-2L7--MZC-1 'dam"q Lot No.
Site Plan Name: S7\f)cvco Block No.
Project Name:���
DETAILED- DESCRI'PTION'OF WORK:
Icy n. �— ►�-�-I ��- Si l
.'CONSTRUCTION INFORMATION:
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:/I,,,, ,, 11
Cost of Construction: $ V n9 A
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE: '
CONTRACTOR:
Name non fbl' nYn'
Address: 1 Q ir.
Name: Jo"'b t
Company: I II r6 M CY C G
City: State: 2jj
Address: 1 IS6 m4T-�Cklf—ul KC
Zip Code: ( Fax:
Phone No.-T-17`1 q q!g
E-Mail:
City: Lc4 Y-State:'_L
Zip Code: .3!ygq Lc Fax:
Phone No
E-Mail rri - d-con
Fill in fee simple Title Holder on next page ( if different
the Owner listed above)
I
State or -county Licen
ItIvalue 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 LAWN INFORMATION:
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:
I
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,
acclessory 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
WI UR LENDER OR AN ATTORNEY Bff4ME RECORDIN R NOTICE OF COMMENCEMENT."
Signatur f Owner/ Lessee/Contractor as Agent for Owner
Sign ure of Contractor/Li nse Holder
ST UNTY OF FLORIDAE OF ` . n .o 1
Iwnu✓i�s—�
ATE OF FLORID
COUNTY OF
The forgoing instrum t was acknowledged before me
this M day of i 20 ?A by
�s 4-�'�y"'1'/✓f�
The forgoing instru nt was acknowledged before me
this � day of t 20 2 �y
�J�— �-c° (mil �
Name of person making atement.
Name of plerson making statement.
Personally Known OR Produced Identification
Personally Known 't/ OR Produced Identification
Type of entification
Type of Identification
Produ ed i
Produced
a
(S' nature of Notary Public- S `I�orid�o&ry public State of FlorldVigntur
Lisa Greer Bharathommission No. mmisslonFF 962 09
s ('
?of r,o� Expires 02/18/2020
of Notary Public- State of Florida
cAtAyP`ti Not Public State of Flori
ission No. r p .(S ��{{Yv
�!� i �a►Greer Bharath
IL c'9$i, og My Commission FF 96270
Expires 0?J18/2020
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COMPLETED
Rev. 2/7/19