HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONS
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: PermitNumber:
SCANNED RECEIVED
BY
s St. Lucie County MAY 21 2019
---- Building Permit Application Permitting Department
Planning and Development Services St. Lucie county
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: 41 qlDo & S7 rA
PROPOSr7ED INP,RO.UE ,ENT LOCATION:
Address: JI U® r� p n'
Legal Description: �d1se� o�((L e/� �0�5 p GnIr;Q C(� IP A I{c/ IG/W eL'-
L IN l II1-T 1 HL 77 �y
PropertyTaxlD#:_ `{S�I ���J� 1 Lot No.
Site Plan Name: ��/�f/ Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
—Electric _Plumbing —Sprinklers _Generator p Roof Pitch
g
Total Sq. Ft of Construction: , 1 C Sq. Ft. of First Floor: I 0
Cost of Construction: $ _ 03 Utilities: _Sewer _Septic Building Height:
MNER/yLESSE --
CONTRACTOR:
Name
e <Ck
Address: a, r..c c cC�Q� t
�`
Company �ClS r ..5�'s
C><1
City: �U({ State:
Zip Code: 3U�t $ 'Fax:
Phone No.
Address' .. „ ,' 7_y.. C
Ue
n
City: I
Zip Code: Fax:
Phone N Q 157
State,
.1 UI2rQ�-ca QO I/e coo •[ON
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail C2S
Gilk
State or County License
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINE E ^ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not
Address:
City:_
Zip:
MORTGAGE COMPANY Not Applicable
Name:
Address: ell
City: State:
Zip: Phone:
icable BONDING COMPANY: _Not Applicable
Name:
Address:
e: I Zip:
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.
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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 he first inspection. If you intend to obtain financing, consult with lend or an attorney before
com nc' work or r ordin our Notice of Commencement.
Sig ere of Owner/ Le see/Contractor as Agent for Owner
Signature of o a or/License Holder
STATE OF FLU A �1
_ LL�D�['
STATE OFF O DA
L �e
COUNTY OF -
COUNTY OF
The for . 9 instrument was acknowledge before me
The fo� �go�j'ng instrument was ack wledged before me
this ayof20� by
thisilQaayof,20� by
LIn„d I1, C'�xa_L'�
LIo M.
(Name of person acknowledging)
(Name f perso acknowledging )
(Sign re of Notary State of Florida )
( gn t e of Notary Public -State of Florida )
yPublic-
Personally Known p od Id ntific o
Type of Identification ARI � r
personally Known OR Produced Identification
Type of Identific chjp c Mu
Produced
Produced vrrwo v. rya
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Commission No. 9. 20"
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Commission ES: Ssp OpI022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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DATE
RECEIVED,
DATE .-
COMPLETED
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