HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 - g —/9 Permit Number: J / 0_1�01WECEIVED
._ _—_ _— -_ Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
AicatiN 8 2019 J
Permitting Department
St. Lucie Couri�y, FL
PERMIT TYPE: / i�e,l'7 1 / » e red S Gt 1
Address: Z i.5 `/ J. lc(/Lc( r x /�r. .'> Y�/S'J
Property Tax ID #: %l ,f —) U/- oG `�6 - Ud�- �% Lot No.
Site Plan Name: Block No.
Project Name:
Additional work to be performed under this permit - check all
_Mechanical _ Gas Tank —Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: /'r K 16 % by Sq. Ft.
Cost of Construction: $4(�pp0.os Utilities:
Ct .; r,:,A i ,
ata}iply:_ 4.�; -
St. Lucie
County
nl_ShutYFs': '
Windows/Doors
Generator
Roof Pitch t
Building Height:
OWNER/t SSEEt
GONTRP,000.R:
RPM
Name -Idt)y I i 1151Ar
—
Name:
Address: 739 f j�GCI�
Company:
Clty: I'Os''r �i /</�� State: FL
Zip Code: 3 V'N'S Fax:
Phone No.-7/7 - �9 C3 — 41.(_21?
Address:
City: Z State:_
Zip Code: Fax:
Phone No
E-Mail: � hIs fd R f) /'16�/LJaiI < 66M
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mai
St a 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 ` CONST UCf ON L)EN LAW INFO
MA11 TZO
DESIGNER/ENGINE'�Applicable : // Not
Name: ® 6A Upti (rlOdz
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:®
Address:
City: ® State: ®
Zip: 0 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 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
.WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
�gS natureiofOwner/ Lessee/Contractor as Age
Signature of Contractor/License Holder
STATE,OF FLORID
ae o,„5
STATE OF FLORIDA -
COUNTY OF
COUNTY OF
The fo Ding instrument was acknowledged b
3r
rre��
The forgoing instrument was acknowledged before me
this day of 20�1&.
I. m�
this_ day of 20_ by
Name of erson making statement.
Name of person making statement.
Person�Y� nown OR Produced Ide
catren
Personally Known OR Produced Identification
Type of Tdentii anon
Type of Identification
Produced
Produced
(Signature o "Itlary Public- State of Florid )
V
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.