HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEi cv FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
s SCANNED
• St. LUCe County RECEIVED
Building Permit Application APR, 3j2019
Planning and Development Services gC�y� PermittingDepartment
Building and Code Regulation Division / St. Lucie County
230D Virginia Avenue, Fort Pierce A 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: con 4r'u C�- eol) e e7k S;Itb UA 1 0C1]'�YS 4j v- I
PropertyTaxlD#: 5`t0c;,1—!v Otb—OQ(o K-0Ch'1/ / Lot No.
Site Plan Name: �' Block No.
Project Name: U] n bkm r 0vi-f Q i,-& of
CONSTRUCTION INFORMATION;
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 7s� Sq. Ft. of First Floor. 7s
Cost of Construction:$ .3,90-0d Utilities: _Sewer _Septic Building Height: in
.,OWNER/LESSEE;: _ ;,;CONTRACTOR::_
Name
PT CS
Name:
Address: SI Ilov. 601 lv'
City: t Stater
Zip Code:�i c1 g a Fax:
Phone No. 41nt -9X71�
Company:
Address:
City: State:_
Zip Code: Fax:
Phone No
�•—
E-Mail: Y-;T j70 vy,eY 0 /,c,6V4k a
Fill in fee simple Title Holder on next page (ff different
from the Owner listed above)
E-Mail
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.
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
Address:
City:
Zip: Phone:
BONDING COMPANY.
Address:
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 concurency 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 I NII+ROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEWNT 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 COMMENCEMdNIT r
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA�A
STATE OF FLORIDA
COUNTY OF r,
COUNTY OF
The forgoing instrument was acknowledged before me
Theforgoing instrument was acknowledged before me
thisg3 dayof�I Q J. D .2&jd by
�D1c1A00" T.e�a�r�.
this _ day of .20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personalty Known OR Produced Identification
Type of Identification
Type of Identification
Produced �i �g,FW
Produced
(Sigridurebf Notary Public- RpF1MiNG
(Signature of Notary Public- State of Florida )
•;• LASHANNAING0RAM'C'G
Commission No. _ `' ; MYC S: ecem o 2
Commission No. (Seal)
• � OF.`SCS �V"�p11b�II1MYw.^-.-
REVIEWS
FRONT
ZONING
SUPERVISOR PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
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DATE
L.qOMPLETED
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