HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a — /Y- /
SS�Jt7�ll7�a'°'I �j
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
RECEIVED
Building Permit-Applicati n FEB 1.4-2019-
ST. Lucie County, Permitting
Commercial Residential ---)�--SCANN
PERMIT TYPE: n C w 9004 St. Lucie C1
PROPOSED INPROVEMENT LOCATION:
Address: 9600 N50 G.able.S i31EIs1 rorT ?,'arcc FG 3i/9S F
Property Tax ID#: 130l - 61l - 0 3oq- o0019 Lot No. 12
Site Plan Name: Block No. / J S
Project Name:
DETAILED DESCRIPTION OF WORK:
Py++ig% on AC&V ,ao+al Roof i L.e tA:Mgr
f-rlr:. - ct { Pvt,'tir ow Pegl ol- S47,Lk
CONSTRUCTION INFORMATION:
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 q . s Pitch
Total Sq. Ft of Construction: (1900 c o� Sq. Ft. of First Floor: _
ao
Cost of Construction: $ 6 S 00 � Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PCs.:+4 1'ca,,y
Name:
Company:
Address:
Address: 660o 10e61cs 131v J
City:J$-�orT P:<,ct State: FL
Zip Code: 3 y 9 S / Fax:
Phone No. 7 72 ^ S' 3a 2 LA
City: State:_
Zip Code: Fax:
Phone No
E-Mall:
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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 Assoclation 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.
Inconsideration of the granting of this requested permit, I do hereby agree that Twill, 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
commencine work or recordine vour Notice of Commencement.
� � irl
Signature of Owner/ ssee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA X!,1
STATE OF FLORIDA
COUNTY OF • L'10'C
COUNTY OF
The fo Ing instru w s acknowledged efore me
this ayof 20�by
The forgoing instrument was acknowledged before me
this _ day of .20_ by
Name of person making statemen .
Name of person making statement.
/
Personally Known OR Produced Identification r
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced F
Produced
j
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida J
Commission No. "lyal, %fiJfN S. NIELSE
e+� State of Florida -Notary Putli
mission No. (Seal)
__ •= Commission # GG 2074
4
J
ine 12, 2022
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Rev.9/Zb/18