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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t Date:.// Permit Number: `� a =d l RECEIVED Building Permit Application JAN 2 2 2019 Planning and Development Services Building and Code Regulation Division ST. Lucie County, PerM14100 2300 Virginia Avenue, Fort Pierce FL 34982 c Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: BY BY III Q8 I grin rTnnnfii Address: _�IRIII; :wT i.T757J7+�✓y�1/�L��7 Legal Description: r c4 d • • Property Tax ID#: d)I,%" 0(30• ?� Lot No. 90V Site Plan Name: Project Name: Setbacks Front Back: Right Side:= Left Side: — Block No. T __ zoo 641A)ELtd 7.ArC art 1�57 1 30/0 �L� s CONSTRUCTION INFORMATION`.. `zr Additional work to e e orme under tispermit-checka apply: �HVAC Ei Gas Tank ❑Gas Piping _Shutters ❑ Windows/Doors Electric 0 Plumbing Sprinklers Generator © Roof Iu Roof pitch Total Sq. Ft of Construction: 0 •D t Cost of Construction: $ to . L 00 . O O S Ft. of First Floor: _ Utilities. Sewer D Septic Building Height: L _54yfM OWNER%LESSEE: :4=' - ;CONTRACTOR Name fO M Name: CcL1Vly% W-'s r_hr)54tY) S-r-A Address: ID••'1 C,114Y-N 1�C - CJtR Company: �RUn4 City J—lfigWl�2&-tit State:• Zip Code:-A*19 )1 Fax: Phone No. 4a3-gJio- agE)S' Address:�SSS�A NE R i I'hDY% 701- City JP•nSLY1 Zip Code: IgrJ1 Phone No.nna- �eC►C� State Fax: 93Li-S/06L•i q34- 14DBL4 E-Mail: — Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: g • �� State or County License•ct C 13Ito aid If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. IAW INFORMATION; `StJPPLEMENTA! CONSTRULTION.LIEN _. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: Zip: Phone: State: City: State: Zip: Phone -FEE SIMPLE TITLE HOLDER: ill Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: d • t II tion as Indicated — OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work an ins a a 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recorclingavour Nonce or l.onmtctit;Sign ctuoi' Sig ure of Owner/ Lessee/Contractor Agent for ure of Contractor License Holder STATE OF FLORIDA / S� GdG v STATE OF FLORIDA COUNTY OF �Lu� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me r Sby this day of .7 P .2C/1 by this IDA' day of Cl✓�n L,��s�L &i)ey) fM �1/lrt L��1 r!/�ld trrt Name of per on making statement Personally Known OR Produced Identification Name of person making statement Personally Known -Y OR Produced Identification Type of Identification Type of Identification Produced Produced (Si ature of Notary Public-St%J of Florida KKENNY (Sign re of Notary Public- Stateof Florid to a Yv1ARKKENNY /� =ot• _plc fflon#GG144499 20 ..,, Commission No. . I9n#GG144499 Commission No. „ , �r esseptember19,2021 o< Expires September 19,2021 o< �TFOF noP Bondadllweudpet NolUySelwke5 or rt' BanOMllw BuEgetNodrySeMms REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW COUNTER REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE Q COMPLETED / Rev.8/2/17