HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'n Permit Number: a.0-0-3-
RECEIVED
- Building Permit Applica ion MAR 16 2020
Planning and Development Services ST. Lucie County,/Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: eV�o
:FRO:POSED INPROVEIVIEIVT LOCATION.
Address:
Property Tax ID#: 2 p= SYM• I1 l ' 0005-• 000•5 Lot No.�_
Site Plan Name: l jjp \&- � Block No.
Project Name: Tc,-A n,YoUS_- _ n
DETAILEDDESCRIPTION OF WORKAr
CONSTRUCTION INFORMATION 4
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator �of Ll112, Pitch
Total Sq. Ft of Construction:
���� , Sq. Ft.of First Floor:
2�
Cost of Construction:$� -I"3� Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name Cv-A u -���, Name:WMAYA '
Address- Y �. Company:
City:B:�P1UU_ Stater Address:(A 0� , la' W/1'afa/ &_
Zip Code:e,2MGn,2,. Fax: Cit e_ State:_P1
Phone No7_112- CJ 0Q, Zip Code: Fax:
E-Mail: " hone
Fill in fee simple Title Holder on next page V different E-Mail 1
from the Owner listed above) Se or County Licens
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
/ MORTGAGE COMPANY: _ —Not Applicable
DESIGNER ENGINEER: 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 propert .A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. I ou intend to obtain financing, consult with lender or an attorney before
commencing w k or recowwng your Notice of Commencement.
Signat re of O n / essee/Contractor as Agent for Owner 5 gnature of Contractor/License Holder
STA E O D STATE OF FL A ,
COU O A�L COUNTY OF��
The fng instrument was acl owledge�More me The f r oing instrument was ackn wledged fore me
this ay of 20 , this day of 20 y
a0-Vd C'o l b_4 .
Name oLP19rson making statement. Name of person makin statement.
Personally Known_OR Produced Identification Personally Known 7 OR Produced Identification
Type of Identification Type of Identification
Produced Pro uced
( ignature cK ffotary Public-State of Flori e o otary Public-State of Flori a -
KATHERINE AVENS o��x P�aG KATHERIIVE V
Commission No. IG����- RTIY"'111 r �� MY COMMISSION G
( ._� MY COMMISSION#@Ei1$Q4 ion No. r EXPIRES:DEC 4, 029
EXPIRES:DEC 04,2021 a° Bonded through 1st U5U(�118�
Bonded through 1st tate Insurance
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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