HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLEI'cu'rOR APPLICATION TO BE ACCEPTED
Date: \�%6\ Permit Number:.
a RECEIVED
-- Building Permit Applicatio OCT 10 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie Cou ty, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
e J O 00
PROPOSED 2MP OUEMENT LOCATION:
Address: 3�7(s hselown Skid F.O lcU �L 3tfRe -
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
D TAILED DE-SCRIPTION OF WOR
New s6eeAcd eocare-, atcld(n(h t,',AdowS on p,&hFt Cnd of eAcloScIrt
I•
CON T UCTION IN ORMATION;
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _ShuttersWindows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof • Pitch
Total Sq. Ft of Construction: boo Sq. Ft. of First Floor:
Cost of Construction: $ N000 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CQ TRACTO
Name 610aV— SOJ2e- Name: AVI wea-)(aG
Address: 31NO R05E)at /t '5Pd Company: - fti l\� aI LLC
City: it)f!'•'�IPIG:•°'°. State: L Address:."7ps,`:S`d�i�+, s1
r., e. • : -..
Zip Code: "�N�c62 " ` Fax:. " Qty•.:: a SQHL 0'I G0. Stater
Phone No. 77d--'fba -827!;;Zip code: 311,'17 Fax:
E-Mail: Phone No �r2'a 37n—�4Ky
Fill in fee simple Title Holder on next page ( if different E-Mail dv(CSl�jtn�wl,o �nafiMw I�.CCY"
from the Owner listed above) State or County License. CDC is in��0
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.
a ' : ° I;€Itrl_�ti� :. 5 D lJ,,,,,�.,lf� u 1•� ���.Slli li , vial, ir'�iitY.,\ 1 � ��.!iESIGNER/EN61NEER' Not Applicable MORTGAGE COMPANY: Not 'Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDAVIT: Application is hereby made,to obtain a permit to do the work andinstallation 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 permittwill 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.
Inconsideration of the granting of this requested permit, I do hereby agree that'I'will, in.all respbas, 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 ATTORNEYaBEFORE RECORDING+YOUR NOTICE OF COMMENCEMENT20"`=<. ' '
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Signature of Contractor/License Holder
Signature o Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF
STATE OF FLORIDA
COUNTYOF
The forgoing instrument was, acknowledged before me
(SV%
The forgoing instrument was acknowledged before me
4 c"4z)
this L day of crt 20 by
this \a day of 20 \� by
v
C'..t :a wte
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identif cation
Type of Identification
Produced L L
Produced V 6 t_
(Signature of Notary P lic='State of FI'o'rida )^ ;NP�gG o�
ignature of Notary P lic- WEAN Gp72o25
Commission No.G6 0 �a I (Sep%,,oust" As
mission No. . �•• •••• oNa
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