HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEi to FOR APPLICATION TO BE ACCEPTED
Date: s- 15-A 1 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Application MAR 13 yplp
Permitting Department
St. Lucie County
Commercial Residential ✓
PERMIT TYPE: SCANNED
PROPOSED IMPROMEMENT MCMTR5N NNOM St. Lucie County
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
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Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 49f4ef
Cost of Construction: $ P,0,.000
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors
Roof 11&- itch
Utilities: _Sewer _Septic Building Height:
0WNERJLESSEE:
CONTRACTOR;
Name $ LGL
Name: A±,
Address: 6.� 2 5 L Shdr Flo✓er AVM
Company: Swi a&t foo4 re, L.LL-
City: RQa 5F Lue-iC_ State:
Zip Code: 34,/g3 Fax:
Phone No:' """ "' " ""'
Address: 91$) 615 to I w,, irn
City: ParWC-e- Stater
Zip Code: 34452-Fax:
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail e b r's.�k,,,.a.•}�) ®� Fiop I( COMA
State or County License /,GC p 3 mo
It value of construction is 5Z500 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.
DESIGNER/ENGINEER:
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:_
Address:
Address:
City:
State:
City:
Zip: Phone
Zip:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
ne:
BONDING COMPANY: _Not Applicable
Name:
Address:
City: City
Zip: Phone: Zip:
]WNFR/ CONTRACTnR AFFII]VIT' AnnIi,ntinn is hcrch,, mo to to nhtnin o narmit to rin tho wnr4 �n,l inctnllxinn x in irvto
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
PO TED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR.LENDER OR -AN XTTORNEY BEFORE RECORDI G.YOUR NOTICE•OF COMMENCEMENT."
Si Lure of Owner/ Lessee/Contractor as Agent for Owner
S' nature of Contractor/License Holder
TE FLORIDA
STATE OF /
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COUNTY OFORIDA I-
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The for oing Instrum t wa acknowledge before me
this ��y of 20 by
The forgoing instrump�r was acknowledge, before me
f
,
this day of V— 20� by
�lTnName
of person making statement.
Name of person making statement.
Personally Known bli Produd Ide ti 'cation
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification
L
Produced L (i
l�
(Signature of Notary'Pubhc- State
of Florida)
Commission No.:6e,,'
(Signature of Notary Public- StateofF
(SeEIJLENVAUGHN
ELLEN V
Commission No. 'c State of Floritle
UGHN
Notary public
;= k- State of Florida -Notary Pul
e Commission sGG 270M
"� MY Commission
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Expire,
'��nno� October 22, 2022
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2, 2022
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Rev 2/7/19