HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
j Date: L-?-ooxPermit Number: a0O`— O SaJ
V. RECEIVED
Building Permit Applicat on JA ?0219
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:
FIRK19M- ,
MR @ I Q IMPR01/E My, EN1 I.00 He " �y
Address: �i7 o4Ve iQly� � 3 j�/
dada,-� c� p-
PropertyTax ID#:• �����3�a � Lot No.
Site Plan Name: Block No.
Project Name:
t)ETAILED WWIPTfON OE ORK:
IF
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CONSTRUCTI®N INFORM TION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters.' _Windows/Doors 1
_Electric _Plumbing _Sprinklers ^Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ (o 0 0 D O Utilities: —Sewer —Septic Building Height:
OWNER/LESSI' : CONTRACTOR:
Name =- RO d n Z Name:
Address: 5115 I N viuf Company-
City: - 12�/iL 2 State: -L Address:
Zip Code: 3 ^q-- / Fax: City: State:
Phone No.�t7r7.4_4 W — T S 9 Zip Code: Fax:
E-Mail: 2S Phone No
Fill in fee simple Title Holder on next p ge(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.
SUPPLEM NTAL CONSTRUCTION LI �N tJ1W IN �ORMPOTtON:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: ' Name:
Address: Address:,
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: - _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 permitiwill,authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rt41q,1.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;iri 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
1VITH YOUR LENDER OR AN ATTORNEYBEFORE RECORDINGYOUR NOTICE OF COMMENCEMENT."
SignaturV_Abw ess Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA i STATE OF FLORIDA
COUNTY OF COUNTY OF.
The for ing instrum t was acknowledged before me The forgoing instrument was.acknowledged before me
this day of Q^ 20M by this day of 20_ by
�-�,,� �.a a •c` vim.2.
Name of person making s atement. Name of person making statement.
Personally Known - OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Pu_bl D �p,MARIEGMNS ��Signature of Notary.Public-State of Florida) '
COMtdISSION#GG 0220^3 —
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Commission No. a 2" :1': �S:December16,2020 mmission No. ;(Seal)
',r• ,-so: o PuWr Undenvd1Q S ,
4I O�F�RP�, BondedThNK 1
REVIEWS FRONT ZONING SUPERVISOR PLANS- : ,VEGETATION . .SEA•TURTLE•,r MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW- REVIEW REVIEW
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