HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/$V2020 Permit Number
L J - RECEIve
•
Building Permit Applicatio MAR 1 0 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 'r C; A02
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: T�'4CifC\ca;AICetnq-CC- A✓14Oa0 elf n."k
DETAILED DESCRIPTION OF WORK:
Renovations and maintenance of County Facilities, to include but not limited to: the repair, replacement and new installation of the following.
HVAC equipment, ductwork, plumbing fixtures, plumbing lines, drain lines, interior walls, windows, doors, counter tops, cabinetry, concrete,
fascia,siding, drywall, acoustic ceilings and electrical equipment. Work to be tracked using the work order system for periodic inspections.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical _ Gas Tank _ Gas Piping XShutters )(Windows/Doors
Electric _(Plumbing _Sprinklers _Generator X Roof Pitch
Total Sq. Ft of Construction: Sq. Ft, of First Floor:
Cost of Construction: $ S 00 b Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 5k L �C- t_ L (0 - A-
Name:
Address: %3 t -gi ✓lt1i Ap-
Company:
City: — , 0-te'HL State:_El-.
Address:
City: State:_
Zip Code: 3 `(`� Z Fax:
Phone No. - H 1,2 - I 1 oU
Zip Code: Fax:
E-Mail &4J Lki e.. S�- ✓, e- CO • rajre,
Phone No
Fill in fee simple Title Holder on next page( if di re
E-Mail
State or County License _
from the Owner listed above)
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.
1 0 2,7.343
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable i MORTGAGE COMPANY: Not Applicable
Name:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
0-3
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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sr. 1tct& Co.✓2j
COUNTY OF r, IF.
The forgoing instru�mr�ent was acknowledged before me
The forgoing instrument wa acknowledged before me
this 9 day of llhfi- .H 20 20 by
this ID_ day of , 2020 by
S--e 'RtiuA
16f,111�LIE.0
w EL4,
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Name of perso making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pu
(Signature of Notary Public - State of Florida )
MELISSAS.BOECKEL
Commission No. `s :!CommijiilW1FF979475
Commissi '... KAREN S. NIEL88rIzII1
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.Z/7/19