HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE,, OR APPLICATION TO BE ACCEPTED `
Date: 'b Permit Number:
(.44k< Cqs` RECEIVED
LAN 0 9 2019
Building Permit ApplicatioPlanning and Development Services county, Permitting
Building and Code Regulation Division e
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
0.\v�rn CwJ6ar�
Address: !;:4-1
Property Tax ID #:
.Site Plan Name:
Project Name:
e
1Jy -daaa- oao=
Lot No.
Block No.
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:
y� r
Cost of Construction: $ \ 1 � O ,
Sq. Ft. of First Floor:
Utilities: `_Sewer _Septic
Building Height:
Name Cz-5
Name:
Como r�4,( l�n[
City: r`_` \ '•cx,' State:
Zip Coddi ' F,ax;
Phone No: OVA �A� �
-any:
Address:r�`-10"l.
City:. - State:�
Zip Code: '3 `t(' l F' �1 O
Phone �
No' �" Q 3 � - `A l'
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
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.
SUPPLEMENT r L GO
fC�% LIEN W IN-4
AT O
DESIGNER/ENGINEER:' _
Name:
Not Applicable
At S
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
''"' `' _
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY: Not Applicable
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 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 forrestrictions 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenekag work or recording vour Notice of Commencement.
e
S re of Owner/ Less
r as Agent for Owner
Signaturo ontractor/License Hold e
FLORIDA
COUNTYOF Sk,
OOF F FLORIDA
COUNTY OF5�-. uc�
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of Jb'r\
20M by "
this `A_ day of �1. v� , 20 by
Jc�� nG�z.
Sa\n,n d-\zta(wNX
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced �'cb L.
Produced t" L
(Signature of Notary blic- State of Florida)
(Signature of Notary 6
... NAMARIE GIVENS
"Commission NO.ir�da
g�IgpMAR IE GNENS
o22023..,.
/ , _ �. ;""a.- / DEAF
"_ Commission No.�d 6 '= MYO M IONfFGG02023
{ ,' C0�"MMI$SION 0 GO
:fW m0er 18,207A :';
�" Deco
,. ��mber%2020
's+ o7,t,.�F GmdedTw Notary Poblla Undanrtit m
Er.
F,�:pIRES: brwUndervifiters
REVIEWS
FRON
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUN R
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
\
RECEIVED
DATE
COMPLETED
Rev.9/26/18