HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ' G�
Date: 5'a a _ Permit Number: 0 l
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Building Permit Application
MAY 15 2020
Planning and Development Services
Building and Code Regulation DivisionU ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMITTYPE: L
PROPOSED IMPROVEMENT LOCATION:
Address: I aoi e G S acc,,A) _,3P, 4,( QC6AA) JUA.)tS
Property Tax ID#: 1 90,9, 0U JA UCV G Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION
CONSTRUCTION INFORMATION:
Additio 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:$ 39 W Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ( 8c-&z ettA('f'C j 1 Name: 7\1 )i
Address: 13 1,6-$s6/Z Otte-0 j OCUJ Company: C_ ,v
City: �L t a d E 1�2' �oo L State:Mr Address: P 114etZyw
Zip Code: D Lf O Ga C Fax: City: -S-t. State:
Phone No. �u`1 21bG 9LA-3 eat Zip Code: 3 K°►lb3 Fax: V
E-Mail: Phone No Mai �,O� a f7A
Fill in fee simple Title Holder on next page(if different E-Mail 5:,l i/U[,MRT ;?,,LS 0 r �4A 0
from the Owner listed above) State or County License ' L 5–
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.
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."
Signature of Owner/Lessee/Contractor as Agen or Owner Signature of ContrCr,/ cense Ider
STATE OF FLO A STATE OF FLOR
COUNTY OF 4a COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this *-4 day of 20� by this�day of 20Zby
91�� O�A�'-A \)C�V-cx'<� h r. (-\4 %(-A \Arl
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Typeof Id ntific tion Type of Identifica ion
Produced X112 Produce /{
(Signature of Notary Public-State I State of Florida (Signature o4ka. ida)
ar My Commission Expires 0 21/2021 ,1{= `e� Lauren Meta
�,OF F�$a ) Commission No.GG 1 7 N ;: State of Florida
Commission No. �l I �m�\��al 4'�mmission No.
o, 4ission Expires 06/21 02
Commission No.GG 11745
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 9