HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INF^O7 �MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �1 c� Permit Number:
RECEIVED
Building Permit Applicati n JAN 15 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
PERMIT TYPE:
NUMEMEEMM
Address: /0'7u2< 5 04rCAr1 rare - F�s�,-► 6CR, 3`I9s`7 16/as'
PropertyTaxlD#: -90v& Lot No.
Site Plan Name: Block No. Project Name: HU7-C 1,J orgy SLAn(b
/2�G44Gc`' ST-A iree^5 r®r✓O 1,4W!)/w Cr .0,4 rAl�rJT
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
Total Sq. Ft of Construction: i C) Sq. Ft. of First Floor:
Cost of Construction: $`fad. ao Utilities: —Sewer _Septic Building Height:
Name fl , jr, r'P L- / Name: f7L C7e347 7z! a
Address: Company: j.Ntil�
City: State: FL_ Address: ! cl 1
Zip Code: Fax: City: % 1-4 LfC)-1z57q L&" State: E'L-
Phone No. :'61 -ZY13 )I G j Zip Code: Fax:
E-Mail: 1i CX&' " Reb m,;) [ `1a fsi. •f r Phone No 960,r '{d 8`L '
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 qr more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED.Notice of Commencement is required.
jF>D2;;rsen,4Z® /��arnrzs' Sim
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: 5C Hi-iTf�
Name:
Address: i,Dfa.J 2J/2 31r4O
Address:
City: V`ZRC' : 614 State: t_
Zip: 3a4170 Phone'77.)--366 yq?R
City: State:
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 Count 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 ATTOR L}Y BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Own essee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA I
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The f r oing instru ent was acknowledged before me
The forgoing instrument was acknowledged before me
thisrMday of 20--10 by
this day of 20 by
Name of person making statement v
Name of person making statement.
Personally Known OR Produced Identification V
Personally Known OR Produced Identification
Type of Identifi
Type of Identification
Produced
Produced
(Signature of No P blic- State of Florida)
(Signature of Notary Public- State of Florida)
;a.> KAREN �,,N ELSEN
Commission No. ; o ec' of Florilfe`-PV��tary Public
= �= Commission N GG 207484
i9 P4
Commission No. (Seal)
22
REVIEWS
OR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19