HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPiEED FOR APPLICATION TO BE ACCEPTED
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Date: � �• � Ct' � �- Permit NumbE
:
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DEC 10 2019
Building Permit Application
Planning and Development Services
Permitting Department
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: V ;Y"' I )F�Q�-e
PROPOSEDr1IMPROVEMENT LtO�CATION:
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Address: i b 1S ' r`1- (err-- r �C q a a-
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PropertyTaxID#: �- �[JO�- oI �a �� -
Lot No 1
Site Plan Name:
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Block No. 1-/•
A,
Project Name: STlrlk d r)
DETAILED DESCRIPTION OF WORK:
$ h k wo
CONSTRUCTION INFORMATION:
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
_
Tot < . Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ d oo Utilities: -Sewer _Septic
Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name !MN\-e S Name:
AddLs��s,,: IR �f�s Company:
city,yt:aV�llv Vkevcz- Stateaf-L Address:
Zip Code:'s;9-\6Ka-- Fax: City:
State:_
Phone,, No Zip o�g-. uS \ Zip Code:
Fax:
E-MaV QLLVW �R(03 CLO1•e0r"\� Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail
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.
Not AppllcaDle I MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: I Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDAVIT: 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, 1 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."
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Sib ` fu-r7o-ffDw eer/Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
�
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgm oing instruent was acknowledged before me
U
The forgoing instrument was acknowledged before me
this day of 4—)2G. 20J,�, by
this _ day of 20_ by
Name of person making statknaent.
Name of person making statement.
/
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Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Id&-tifF Lion n
Type of Identification
Produced / L
Produced
(Signature of Vary Public -State of Fl6ricla)
(Signature of Notary Public -State of Florida )
Commission No. ;+:e^.i^;'-•• AUDREY REY
Commission No. (Seal)
MYCOMMISSIONkGG300817
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of
Oond
Thru Notary Public
denvriters Ik
REVIEWS
°FfC;W
VISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19