HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE
FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: �q 0+ 0411
SCANNED
BY RF�EI�Fo
St. Lucie County APR j 9
Building Permit Application Permitt. zo1
179
Planning and Development Services st Lu`teo0 untyeot
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_
PERMIT TYPE:
P.ROPO5ED1NIPROVEMENT,LOCATION
Address: '7101D Se-lbas— o-n Pd r Fo(+ Pierce, FL 34951
pertyTaxlD#: 130 )-W L 03OS-000--I Lot No.
Site Plan Name:
Project Name:
1
eE& `� lJJ r� Y LM1. 1�:.A] 11gyyd T VMJ�3'
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 Pitch
Sq. Ft of Construction: -!X00
If Construction: $ %000.0�
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER%LESSEE:
CONTRAGI
OR'
a\ D
Name ,Uzc-�-,
Name:
Address: rllo0 g-h aa, Pad
Company:
City: FJAx - pierce State: ELL
Zip Code: 3" 51 Fax:
Phone No.-77.2- -" 7-gjgq
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: hec4C, i,.-\53 P amlt.'l • com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST-WICTFON LIEN LAWINFORMATIQN;
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Ai
Sig re of Own / Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF S$� ,Q; 0
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thisLdayof',_0 .20ig by
The forgoing instrument was acknowledged before me
this _ day of .20_ by
Name of personmbking statement.
Name of person making statement.
Personally Known OR Produced Identification'
Personally Known OR Produced Identification
Type of I entific ion
Produced
Type of Identification
Produced
ftfiatdre of Notary PubliA State of Florida-
Si natur
of Notary Public- State of Florida )
ordY•.,
`-.,•�'•�.
Commission No. ei v'e" Q"dkwNwvi
R vz-c a4w9woua:931lIdX3j
090SLZ oo 0 No1SSIWW0111AYi
n No. (Seal)
REVIEWS
FRONT
COUNTER
ZON
REVIEW
PLANS VEGETATION
REVIEW REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
SUPERVISOR
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19