HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1�; - I
Date: 1 Permit Number: u1
RECEIVED
o -
- --- Building Permit Applicati n APR 2 2 2019
Planning and Development Services Sr. 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: F J�rlcc�l Y SCANI
Y.- BY
PROPOSED IMPROVEMENT LOCATION: St. Fucie Count
Address: i0-\09- Nfl U-V)A
PropertyTax ID #f: 3 - (o- - Lot No.k
Site Plan Name: 1b, i rUM "W—n-� Block No.
Project Name:
DETAILED DESCRIPTION OF WORK;
Z.n.SI-n1I flP_Y1P✓C Y'`i'rQY1J-ter S1.�I�C� ay-6 a-'� QPY12'lc�'7W�
CONSTRUCTION'INFORMATIONi
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Y Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ) S.4
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE; . • ' '
CONTRACTOR:
Name Rcbpr+ L.4 rS b
Q �WIS
Name:
E , Ho-+,Jt--
Address:lalJ'l- %IrYiS4)o(1A
1-n •
Company:I`ic\fitl0. czy-1 r(ac+w-s
City:
Zip Code: '3HOF,3ti Fax:
Phone No. I'la— 41, 5-11R1a5
State:£1
Address: iQIOVJ. HI&I
City: Stater
Zip Code: 3 Qa X Fax:
Phone No 198- LlI 0I- asa1 `
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail pfY1e-,Mn+a1l), CD(n
State or County License eo- I 01(3
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
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."
Signat r@ ,{ Owner/ Lessee/Contractor as Agent for Owner
Signa r of Contractor/License Holder
STATE OF FLORIDA
STATE O FLORIDA
COUNTY OF ��IF
COUNTY OF
The for oing instr ent w s acknowledge before me
this'�,day of 20� by
The f.SQ�,r��o,ing instru ent wq acknowledge efore me
this al�day of 20�by
t �� �1rlr�t�
t� � � 1�
Name of person makings atement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced ,
I
(Signature of Notary
(Signature of Iota Public- State of Florida )
Commission No.
KAREN S. NIELSEN
vF.°`a:'- a -Nora, Public
�� -State of (SeafJ y
"""' KAREN S. NIEL
Commiss r: "'- 1
bd�)
S Commission # GG 207484
_ �' a -Notary
„? My Commission Expires
�
'- 'E Commission # GG 207484
P'
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na 12, 2022
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Rev. Z///19