HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:��� �c�Ga� Permit Number:
55 W
�-- r - RECEIVED
COUNTY MAR 2 9 2020
Building Permit Application
Permitting Department
Planning and Development Services St. Lucie county
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _
PERMITTYPE:
I P1 OPWSED LlM R ROUEMEN ird 11n.-r.TAWd ON'
Address: ll� C2
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DET FLED MNMPTiON W MOR
1 a0 ASW
CON RUCTION IN1FORMAT)ON:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters )-4 .WinclowSED
_Electric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
O
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
(3WN`ER/LESSEE: CONTRAGTC)R:
Name c Name:
Address: _ Company,:-
City: State Address:.
Zip Code Fax:/ City: State:
Phone No. _ - ap Zip Code: Fax:
E-Mail: S 01 a � , /fit Phone No .
Fill in fee sirl4le Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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. .
SUPPL1 'ITE It N RNLCCO
DESIGNER/ENGINEER: Not Applicable MORTG E MPANY• Not Applicable
Name: Name: q/JJ �✓fnrS
Address: Address:
City: State: City: State:
j Zip: Phone Zip: Pho e:
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 ,`j 1 JL,-r COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this.�27 day of 120 Zr by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
ProducedProduced
U
(Signature of Notary Public-St of Florida) (Signature of Notary Public-State of.Florida)
9�
Commission No. (Seal) ; ®;_ Commission No.. (Seal)
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REVIEWS FRONT ZONINGI ERV PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE d a o°.m
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COMPLETED ^'m 7:
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