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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CC._..'! ETED FOR APPLICATION TO BE ACCEPTL_ Date: Permit Number: 19©3 -o(o ff— SCANNED BY St. Lucie County RECEIVED Building Permit Application MAR 281019 Planning and Development Services Permitting Department Building and Code Regulation Division `\St. Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 'I.- ` PERMITTYPE: (<O,cr PROPOSED INPROVEMENT LOCATION: Address: 14 35- r.nr)9-nh&i1 t- Pd F:�-iBYZ:e Property Tax I D #: Project Name: _ DETAILED DESCRIPTION OF WORK: lame- e9(- Zz isfe -)6 Me-,4 CONSTRUCTION INFORMATION: Utilities: Sewer Cost of Construction: $ Total Sq. Ft of Construction: / c!O 0 Lot No. FLOODPLAIN DEVELOPMENT PERMIT for structures exempt from Building Code that are in the - floodplain: Nonresidential Farm Building: 'Temp. Bldg./Shed used exclusively for construction Mobile/Modular for temp. construction office: Bldg. involved in distrib. of electricity:. Other: Flood Zone: .. BFE:_ '. Fldodway? Y/N,. If Y,. , . No Rise Certificate with supporting data attached? Y/N All other applicable state and federal permits shall be obtained prior to commencement of construction. OWNER/LESSEE: CONTRACTOR: Name No ! Name: 13n a`I n Address: 1 � (7()p )i NJL I/2iCd 11.. Company: �tAwn6 OPT LCI tG dry �_nC City: F; ptpr' State: Llr Zip Code: 304,; Fax: Address: tJu PW& City: r C Stater Phone No. %%A�' 3��i-359 Zip Code: �J � {� �t Fax: _ Phone No 3v -701 % 1 vYls E-Mail: IV" Fill in fee sim -pilie Title Holder on next page ( if different from the Owner listed above) E-Mail State or County License Ur,Ir!> Z$03 J Urlacn 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 ncJJRDED 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 TITLE HOLDER: _ 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencine work or recording vour Notice of Commencement. Signature of Contra or/License Holder Sign Vre of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA` COUNTY OF � Laa& COUNTY OF foW rJ C The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this)I �(dayofj2 20B by this (dayofsTp(�- 4 �Ciby 6 icl ` nlack of person making statement. Name of person making statement. ally Known X OR Produced Identification Personally Known aa w1�R.Pro f F 1pi Ic M ;pe f Identificatio : Type of Identification _ . ;•E MY COMMISSION # GG090412 ced Produced ••„q.,,,6'MAr'Kt:S April 04, 2021 ii/ (Si nature f N �{ " . (Signature of Notary u lic- State of Florida ,,� . 4s%' Commission#FF915261 Commission No. January{ Commission No. (Seal) '�; 9vd•dihuTigiri���pYS7019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 1/9/2019