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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date: Permit Number: 02�0� o7oo - ' RECEIVOID a► - y Building Permit Application MAR 3 12020 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: UP �,rzJt G✓;Axis i.� t.i /itiJ:i"17c>�✓s PROPOSE© I PRUVE�MENT M0 .0 : Address: 7-^ CJ�� !'��,:�to 17 �%. ���:-cam f 7-V`J— T, l I�7 Property Tax ID#: 5 01 6�R 0 A6C 000 b Lot No. Site Plan Name: Block No. 3:0 Project Name: D A L�D D=�St�R�1PTIUN OF 1ltlOR �4. nciT 0&2 Aekc-r 4),'-t-4 /4 4 �JaNOd ' CON TRUCTION IN -ORM TION: 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: II Sq. Ft. of First Floor: Cost of Construction:$ 0 l0,6 Utilities: —Sewer —Septic Building Height: FNanLESSEE: CONTe Name: Address:70,2k'e"J L-J.J nib. Company:--. city: 1--t- State: Address:.7Zv 7: Zip Code: .. YDS/ Fax: City: State:;i%/ Phone No. Zip Code: Fax: E-Mail: Phone No 77. �a /'7:57F Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License ZCi 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. mu mmmm mwaw=tm uw IN R O : DESIGNER/ENGINEER: >`-Not Applicable MORTGAGE COMPANY: '�O-PJot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPIfEJTITLE HOL,DR: Not Applicable BONDING COMPANY: Not Applicable Name:_ �.�e�a<4ti ( //; Name: Address:' Address:j�a,�m��) � � Address: City: n� City: Zip:7c26/ Phone:,772 -gip 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 FOR7TH OVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED O JO TE EFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT 1IrITH'YOR OR ANIATTORNEY,BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Sig ure o wner essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA 1 STATE OF FLORIDA COUNTY OF I��',It COUNTY OF The agoing instrugent vs acknowledged before me The forgoing instrument was acknowledged before me this 1 day of 20?L by thisday of 20_ by —'� r,YO, \�. Name of pers n making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Id tifi tion Type of Identification Produced Produced P AA (Signature of Notary Publi = ignature of Notary Public-State of Florida,) KAREN S. NIELSEN 4Ay PUB�i Commission No. �_� ��-Sta��e�l)Florida=Notary Pub i mmission No. (Seal) _* •= .Commission # GG 20748 =� my Commission Expires june 12, 26- -'fFOr REVIEWS FRONT Z NG `SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19 C 3 yc, 3 ®0 a