HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:—( - LA- 21a
() I 0 Permit Number:
• " RECEIVED
Building Permit Application JAN 0 8 Z019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line St ! B � i.III
PROPOSEDIMPROVFMFNTIOCATION ` VufI
Description:Legal � . .
Property Tax ID
Site Plan Name:
Project Name: t l-P✓ZN C .
Setbacks Front Back:
�I of PG�I
Right Side:
Left Side:
Additional work to be ertormed under tis ermit-check a a
11HVAC Gas Tank ❑Gas Piping _Shutters
11 Electric 0 Plumbing ❑Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ �5EQZ - 00
S Ft. of First Floor: _
Utilities: Sewer1:1 Septic
Lot No._
Block No.
QWindows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE: `
CONTRACTOR:
Name
Name:I�'l�"IiC�Q.?Afr
Address: '67�% ✓A �(C1
Company: b4i'1Ar2o'('
City:v<s7t —_-st Ck�i 4 State: -1�1,
Zip Code: �� q a, Fax:
Phone No.
Address: 1n iG• 24 dQ f
City: y _ e /G -Uack? State: FL -
Zip Code: 3oi�jd2 Fax:���Sf7U
Phone No. %%i'5Co% >>-/�
E-Mail: C)\nl ICR,(ZiC Ct-11-)-) @� GVV1(A.1 •CC,)M
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: O ICn irj i/JYIOi
I State or County License: _ C ✓C 7��0i I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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APPLICATION IS HEREBY MADE TO OBTAIN A PERMIT TO DO THE WORK AND INSTALLATIONS AS INDICATED. I
CERTIFY THAT NO WORK OR INSTALLATION HAS COMMENCED PRIOR TO THE ISSUANCE OF A PERMIT AND THAT
ALL WORK WILL BE PERFORMED TO MEET THE STANDARDS OF ALL LAWS REGULATING CONSTRUCTION IN THIS
JURISDICTION. I UNDERSTAND THAT A SEPARATE PERMIT MUST BE SECURED FOR ELECTRICAL WORK,
PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS AND AIR CONDITIONERS, ETC.
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.
A CERTIFIED COPY OF THE RECORDED NOTICE OF COMMENCEMENT SIGNED BY THE OWNER, SHALL BE FILED
WITH THE PERMITTING AUTHORITY IF THE VALUE IS $2,500 OR MORE, EXCEPT HEATING OR AIR CONDITIONING
CHANGE OUTS LESS THAT $7,500.
NOTICE: IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTRICTIONS
APPLICABLE TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THE COUNTY, AND THERE
MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER
MANAGEMENT DISTRICTS STATE AGENCIES OR FEDERAL AGENCIES.
ANY CHANGE IN BUILDING PLANS OR SPECIFICATIONS MUST BE RECORDED WITH THIS OFFICE. ANY WORK NOT
COVERED ABOVE MUST HAVE A VALID PERMIT PRIOR TO STARTING. IN CONSIDERATION OF GRANTS, THIS
PERMIT, THE OWNER, AND THE BUILDING CONTRACTOR AGREE TO ERECT THIS STRUCTURE IN FULL
COMPLIANCE WITH THE BUILDING AND ZONING CODES OF THE CITY OF SEBASTIAN.
COMMENCED. ALL CONTRACTORS MUST HAVE A VALID STATE CERTIFICATION, STATE REGISTRATION, OR
COUNTY COMPETENCY PLUS A COUNTY -WIDE LICENSE PRIOR TO OBTAINING PERMIT.
(ALL A 8RI S AL IFATI0�1 OR EPA1 5 MUST HAVE OWNER'S SIGNATURE N APPU ATIO R P VIDE OF CONTRACT)
:• SIGN TUR OW J AGENT QUAL FIER'S AT R
Erik F. DeLanev Erik F. DeLanev
PRINTED NAME OF OWNER/AGENT PRINTED NAME OF QUALIFIER
DATE: l ' C( ' a0 / 7
DATE: /, </ • --�?0/!
Individuals who sign as the owner's agent must first obtain owner's written authorization to sign on their behalf
STATE OF FLORIDA
COUNTY OF
""NOTARY IS FOR QUALIFIER'S SIGNATURE*"
I hereby certify that on this `I day of 20 19 personally appeared
,(t r r-7 D-P LG✓1 e� who is personabl known to md or has produced identification.
Type of identification produced:
Ictal Signature of �taryblic No
;"?k
AMANDA S WARREN
y,Y COMMISSION p GG149063
'�fEXPIRES October 06, 2021