HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICJ LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Lf� SCANNED Permit Number: _
I+S ` Ye.. sY✓T' `r'. BY
J.
--, St. Lucie County
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RECEIVED
-----=—=-�—'" MAY 16 2019
_ Building Permit Application
Planning and Development Services Permitting Department
St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, FortPlerce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE. Lf'�cbl �d r 3� QA
PROPOSED IMPROVEMENT LOCATION:`
Address:
Property Tax ID #7�1 t —/f/ �5 (J U_C)-ll Lot No.
Site Plan Name: y b )1 13 — d a Block No.
Project Name:
'AILED DESCRIPTION Ol� WORK:
ITONSTRUCTION INFORMATION:
Additional work to be perforated under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
✓Electric _ Plurhbing 1 _ Sprinklers _ Generbtor Roof Pitch
Total Sq. Ft of Construction: ,6i �� T • Sq. Ft. of First Floor:
CSFs Rf_10hstruytilnay� Utilities: ,Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR!
Name
C
Naa?nk4?PA7'P,.C.
r
Address: g
Company
,
City:
Zip Code: Fax:
Phone No. O
State: _
/ 219
Address:
City:
Zip Code:
Phone No
Stater
Fax: T
E-Mail: / UPi
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
Qtr,
Stat or Co ty.license
C �?�
It value of construction is 52500 or more, a RECORDED Notice of Commencementts required.
If value of HVAC is $7,$00 of more,, a RECORDED Notice of Commencement is requirgd. ,
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
Name:
Address:
City:
Zip: Phone:
COMPANY: —Not Applicable
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 anyapplicable 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 INSPECTIONL IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Jam/ lyY 2Z/_
Signature of ner/ Lessee/Contrbctor as Agent for Owner
Signature of 06ntractor/License Holder
STATE OF COUNTYOFORIDACP_ d` Cg _ _ Q
STATE OF ORIDe�_ fJ (J _ _ i /
'/me•=
COUNTY OF'
The for oing instrument was acknowledged before me
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The for oing instrdm ntrwf wasacknowledgedbefore
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this day of 20 by
this day of N . 20& by
Name of p rs n making statement.
Name of r n'making statement.
Personally Known _�OR Produced Identification
Personally Known , [/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
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VEGEtATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
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DATE
COMPLETED
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Key. 217119