HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED./
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Date: 2-- �)'O g Permit Number: d✓ Q� I
RECEIVED
FEB 0 6 2020
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Building Permit Applieationrmitting 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: V-1t1::) �L
Address: O n
Property Tax ID #: `L y 2 i e5 a !- .O o 6'o , C> o o p Lot No. 9_
Site Plan Name: Block No.
ProjectName:
e Jed �r� '49. enn" Ol
hzo
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Additional work to be performed underthispermit -check all that apply:
,Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric /Plumbin`g, _ Sprinklers _ Generator —Roof Pitch
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Total Sq. Ft of Construction: CJ 0 Sq. Ft. of First Floor:
Cost of Construction: $ / SO O Utilities: —Sewer _Septic Building Height:
Name i, e i l aaw r '14- Name: /00e.yt t lwM�
Address: Zoo S . -3. � A S 6"e- Company: zdclea 15 .. A: / /,. -. J✓1
City: Fo/7" Miler` � C St' ate; �4 /
T— �✓r Address: /f/7 /.it�.✓oo0 �1
Zip Code: 34/98?Z. Fax: ?V VO9- V 32? City: /Cerf /d3krec State:
Phone No. '7 72) Sao 9 • Y "'i 7 6 Zip Code: ? y 9 $ t Fax:
E-Mail: Phone No 7 2 2 er
Fill in fee simple Title Holder on next page (if different E-Mail Pre 4, -L711 R Y
from the Owner listed above) State or County Licens ~1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirc
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
d.
FEB 6 2020
Permitti.nq Department
t. Lucie oun ,
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: .`��n rlPJ7 ZlJcr�O�
Name:
Address:
Address:
City: av? G✓G 4Z�State: �G
City: State:
Zip: Phone .1 '91.7 2
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 Counttyy makes no representation that is granting a permit Will authorize the permit holder to build the subject structure
is in Home'Owners Association bylaws or and covenants that may restrict or such
which conWict with any applicable rules, prohibit
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."
of
Signature f ner/ see/Contractor as Agent for Owner
Signatur ra old
STATE OF FLORIDA
STATE OF FLO
COUNTY OF �
COUNTY OF
The forgoing instrumggnt was acknowledged before me
The for Ding instrum� �-w1as acknowledged before me
this � day of ib 20,, by
this � day of +6 20_noby
62(�ne -7-P
Name of person making state nt.
Name of person making state e .
Personally Known OR Produced Identification -
Personally Known OR Produced Identification
Type of Identification (- t�
Produced _ �.t 1 \iA,Ll� 17 ✓• �I�SS�'d'-Produced
Type of Identification
(Signature Of [a
(Signature of
AUDREYB.H PHREy
Commission No. • , c0hB W"UG030081T
r' AUDREYB.HUN101.1
Commission N +i :•_ M'OOMMISSION>RS 081T
EXPIRES March 6; 2023 ..
` g•M1oS••' payy�0 pgn
IRES: March 6, 2023 .
Ri,}�$+ 6uMe0ThNHolayPYble INIOBIMdM
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.