HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 007
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Date: q`, Permit Number: (�
Gil= orIVr.r-)
MAY ® 5 2020
__. Building Permit Applicati n
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: p J�
PROPOSED IMiPROVEMEUT't A 10_N:
Address: �so S-2 (� �, r b e
Property Tax ID#: y��-"1 c'� 1 - � d31- ddo-� Lot No.
Site Plan Name: rte, A r 4,n-Lr &,--FCA _ Block No.
Project Name:
DETAILED DESCRIPTION OF WORK.
Tf C�� 51 (�o��ctc , �U:[ t/ h11clC 300 0" 4S! 07
t''1�e.r .ru��. Ca�c� ��L � `',a��'•
CONS,TRUCTIO'N'liNEORMATION':,
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, Sq. Ft.of First Floor:
Cost of Construction:$ (S� O Utilities: —Sewer —Septic Building Height:
OWNER/L'ESSE€! ; CONTRACTOR;
Name �0�' �� SIS Name:
Address: 6. So 99 t ? Company:316- [ _coag ('_"te_ PIV S
City: f.R S4 Lm fState:f L Address: 82-IJ 0
Zip Code: 3qoil?3 Fax: City: fod s� t ocl-f— State:::5L
Phone No. 772 2S'S � 71 � 3Zip Code: '3ti�a 7 Fax:
E-Mail: Phone No 77 21 (P -1.?!Z 61
Fill in fee simple Title Holder on next page(if different E-Mail n T C o bei' ,1C4Vk, (21v ..4 (5 "1.
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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.
1 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 S E BEFORE THE FIRST INSPECTION. IF YOU INTEND TO T N FINANCING, CONSULT
WITH YOUR LENDER 9WANORNEY BEFORE RECORDING YOUR NOTICE OF EMENT."
Signature of Owner/L see Contractor as Agent for Owner Signature of Contr or/License Holder
STATE OF FLORIDA STATE OF FL RIDA I , ,,
COUNTY OFFS I,�,t,C�(� COUNTY OF 6� t -Ole,
The forgoing instru ent was acknowledged before me The forg ng instry� e t was acknowledged before me
�
thiay of 202ay this 20 2-ay
no U-c-h
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identa. ation �, Type of Identifi ; not,_
Produced Produced Y
(Signature_of Nota Public-Stat ture of Notary P blic-State of Florida)
A oENotar
ommiM.CICIREL 0
Q` �n(� o�� ° lic,State of I q A TINA M.CICIRELLO
Commission No. "`+� 1 _ lic, GG-95of 8 4dpn ission N `� _ °m�� edry Public,State of FI ri
95
Commission#GG 9586 4
xpires April 1,2024
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