HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: a.L/03 ' d 70
RECEIWD
Building Permit Applica ion APR 0 6 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
PERMITTYPE:
PROPOSED IpMPROVEMENT LOI.CATION:
Address% �� O� N.E.D6etarsec' C,+ %rT ST.L C11-_�L 3Liri5'D_
P�9perty'Taz ID-# L4 I g ^ S O -09-a 10 - 000— I Lot No.IA
Site Plan Name: Block No. _ j $_
Project Name:
ILA`
ttq v ah:!14AV
Yh" . my,� a i0 1io1Cl
Additional work to be performed under this permit -check a I I that,#'ply:
•�i:.a .�iAJ. l.t
_Mechanical _ Gas Tank —Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft_of Construction: OW
• Cdst�truction: $
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER"/LESSEE:
CONTRACTOR:
I:Name3' (-CAName:
Addreesss.5 _ C
Company:
}City: l6r-r ST, Lucy State:0t'
2
Zip Code:3H Sa Faux::
(Phone No. % 7 `�- RM-9-5- 7 I
Address:
City: State:_
Zip Code: Fax:
Phone No
V_-Tfail.77
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
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.
M.
16
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. ANOTICE 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:"
401,
ev.
SUPPLEMENTAL CONSTRUCTION LIE-N LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Sigriatureof Owher/;L see/ ntrac[or as A nt for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA �
STATE OF FLORIDA
COUNTY OF BARBARAMILILLO
COUNTY OF
otary u u:- tateo Flontla
�+ om ssi G 7991
The for oing instrument a5, , ,• We ee�beeioo�e rrh�
thisda of P yyromm. Cxpires Ju 12, 2022
y D
The forgoing instrument was acknowledged before me
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
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
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