HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
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Building. Permit Application MAR 2 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:
PR�P051D PK2C}UEN(ENTLOCATI{3N.
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Address:
Property Tax ID#: 1�3 a " d��$ -d d0 ` 1 Lot No.
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit-check all that apply:
_Mechanical 0Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1 ady o Utilities: _Sewer _Septic Building Height:
C)1NNERJLE551= � s,r, CQNl'R=ACTL}R
Name lxe;'"o Name: 4
Address: 600 45;11 0,1y, �z �� Company: kf��A Q
e-3e c��j State Address:
Zip Code: .33 /�� Fax: City: I State:�C
Phone No. 7k6 - ge�9 Zip Code: a Fax: rC` (n ao/
E-Mail: Phone No ® - ^ G Q
Fill in fee simple Title Holder on next page(if different E-Mail CW L . 00
from the Owner listed above) State or County License Crr(a 02312,0
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.
SUP1? '8 IENT I CONSTRUCTIGN LIEN LAW INFORMATICIN
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:
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."
6
e of Ow er/Lessee/Contractor as Agent for Owner Signature o ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF iP;9�,L�i;`C�' fOLt2y COUNTY OF o� ijfGe /rc2r/f! r/
The for oing instrument was acknowledged before me The foaoing instrument was acknowledged before me
this day of /1�'�rte.A- 20 1 by this day of &ITA2010 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identifecil ion Personally KnownOR Produced Identification
Type of Iden UHURA L iNALI Type of Identificati�
ti
Produced :#;' �tNISSION�3C,080 G . Produce HU
%'�'Ia,,,•••, EXPIRES March 07,2021 •• •`=MY COMMISSION N GG030M
d.
Ile_
o r EXPIRES March 07,2021
(Signature of Notary Public-State of Florida) (Signature o o ary 0 u ic-State f Flor' ajd
cpr
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19