HomeMy WebLinkAboutBuilding Permit Application1Y:
All APPLICABLE INFO MUST BE COMPLL. �a FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planting and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROP '$EO;INPROVEMENT LOCATION:
Building Permit Application RECEIVED
SEP 2 7 M19
Permitting Department
St. Lucie County
Commercial Residential_
Address: �jOQ S'e V\r k c.SC�R -lk- - �'� e v C.� t i-L • ��L[ (71
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
IbETAILED DESCRIPTION OF -WORK:
GONSTRUCT(ON INFORMATION:.
Additional work to be performed under this permit -check all that apply:.
Mechanical _Gas Tank _Gas Piping XShutters Windows/Doors
( Electric Plumbing _Sprinklers _Generator ,Roof Pitch
Total Sq. Ft of Construction: Q 61 Sq. Ft. of First Floor: /6 C) 3
Cost of Construction: $ /Sfo ,39C1 Utilities: _ Sewer Septic Building Height: /61
OWNER/LESSEE:
CONTRACTOR:
Name lsJ
Name:
Company: UoJ _\ (-L.C.
�-
Address:33c--U cVo u.,fix' •16(
City: State: _
Zip Code: *I-?r-((C) ala-3
Phone No. -L(S -S - )-A Lk 5
Address:3300 QKQS�_�
Ste 101
City:6
Zip Code: a
Phone No 4{ ( Lt
State: Mc.
33(0- 8) 3
3
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mai
State or County License
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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.
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SUPPLEMENTAL
UtbJUNtK/tNtUINttK: ,NOT Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: �CNot Applicable
Address: I Address:
City: I City:_
Zip: Phone: Zip: _
Phone:
)WNER/ CONTRACTOR AFFIDVIT: Aoolication is herebv madeto obtain a nermit to do the wnrk and incralintinn ac nai ate a
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 accessary 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencinIg work or recording our Notice of Commencement.
i
gnature Ownel Lessee/Contractor as Agent for Owner
Signature of Co tract /License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTYOF
The forgoing instrument was acknowledg d before me
The forgoing instrument was acknowledged before me
this .day of pp�iL 204 by
this 1 day of 11�\ 20_tSi� by
Name of person making statement.
Name of person making statement.
Personally Known_ OR Produced Identification
Type of Identification
`+"""�� E
Personally Known odM�ND'ONOFRlO
y�p�23755a
Type of Identification :!'.:
EXPIRES:August5u
Produced
': ,e`' rwmmieers
Produced NWarY Fl+b e
ignature of Notary Public- State• KAREN 0 uriott
of Notary Public -State o;id)
GCommission
MYCOMMISSION#
No. s�5FXPIRES:August
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diie�+Ytles n No.�`tS:'COMMISSION#GXPIRES:AugustS.REVIEWS
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FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEAANGROVECOUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REREVIEW
DATE
RECEIVED
I
DATE
COMPLETED
Rev.9/Zb/18 -[ Ul�