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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED - Date: l 21 - 19,— Permit Number: SCANNED RECEIVED BY •i St. Lucie Ccul�ilding Permit Applicati n MAR 2 ®2019 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: NPR@IP_G'SF-h 1VIPRk]\7FMFNT I nr-ATinm- Address: Property Tax ID#: k�2n -n(D` • S; 1 ^ co_ J Lot No. ?-qv Site Plan Name: Project Name: CONSTRU.0 111111 Rt kR IATION° Additional work to be performed under this permit -check all that apply: Block No. _Mechanical _ Gas Tank _ Gas Piping —Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator )� Roof E511Q Pitch Total Sq. Ft of Construction: hi % (j� f;0t-P+ Sq. Ft. of First Floor: Cost of Construction: $ \ ©LCl Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: a Jb�::: CONTRACTOR.w,...:., a vw ,. _. Name 1�*y- -fl St` ,AP,C Ibne: Address: Company:�a City: State:-V-� Zip Code:3\�M)k &-A Fax: Phone No. Address: % 1`1 1�- - S-T'- City: ve Lrp der ,h Stat = Zip Code:,j2110 C) Fax: ~1q U • o43 1 Phone No ' L, 0 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail ^ o 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. S_U.P.P.EMENTAL CQNSRUCfI'®N LIEN LAVI7�INFO.RMATI®Ne DESIGNER/ENGINEER: _ Name: Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: _ Name: Not Applicable BONDING COMPANY: Name: Not Applicable 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 orand covenants that may restrict or prohibit such structure. Please consultwdh your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of thisrequested 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 RECOROINC YOUR NOTICF OF rOMMFN[FMFNT_" j;E7- ignatureo Owrier/-Lessee/Contra oras:Agent-far Owner - Signa Contra r/License Holder STATE OF FLQE�DA STATE OF F COUNTY OF �C�Q\fit 1��� COUNTYO -� The for ng instrument was acknowledged before me �` Th f r oing instrument was acknowledge before me this y of � lCC�r� 20� 6y this ay of V.M C z7 20 by Nameofperson making statement. Name of person making statement. Personally Kn OR Produced Identification Personally Known\,go OR Produced Identification Type of Identifi ation Type of identification Produced Produced Pu lic Stale of Floffde rt'i Notary Public Stata of FlOnda (Signature of Notary yitl9 r%ntision GG 2Sno9 (Signature of Notaryu I' t ter fj{f I n GG 25se r FxpiMS 0901412022 ww Expires 09114/2022 Commission No. O"' Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. L/ // 17