HomeMy WebLinkAboutappAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: u. ( Permit Number:
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RECEIVED
JUN x 7 2019
Building Permit Application_
n,itt,ngoep�rt���t
Planning and Development Services
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Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
Address:
Property Tax ID#:-* 1 3DI-(ol�t-De2-7.3 "D00'6
Lot No.
Site Plan Name:
Block No. _ 3Q
Project Name:
AILED DESCRI TION OF WORK:-
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r,-f Iyi-9" Wtd s`.,;Wttuiva
per
Additional work to be performed under this permit -check all that apply:
—Mechanical _ Gas Tank A _ Gas Piping _ Shutters
_ Windows/Doors
N
it4Electric g� _ Sprinklers _ Generator
_ Roof Pitch
Total Sq. Ft of Construction: Ind, /0 loSF Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic
Building Height:
Name -I S Name:
Address: L106 leiriji,,(Lnd ✓1e4. Company:
City: . nl GrcZ State: _rJ- Address:
Zip Code: 3 Lt 51 Fax: City:
State:_
Phone No. -7i a - 5I q - l 3 3 9 Zip Code:
Fax:
E-Mail: <4 r.Ke4ayls772C 6A,,uc I,caa, 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.
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 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
wrirH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sig atu of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFy< if
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this2SIay of _hr�& , 20A by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification x
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Producedl�)2ii?60_
Produced
m�s /14A
( nature of N tary ublic- a of FI CNWOPhuJ. F
(Signature of Notary Public -State of Florida)
/n�� NOTARY PUBLIC
Commission No. ara Z2Z_7C6 STATE OFFLO
IWbmmission No. (Seal)
Ca nrr* GG2227
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/ // 1`J