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Home My WebLink AboutBUILDING PERMIT AAPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: P05 -otpn�b SCANNED N! 7J I BY St. Lucie countv RECEIVED Building Permit Application MAI 2 3 109 Planning and Development Services _tt�ng oop,,t .. ent Building and Code Regulation Division Perm, te County 2300 Virginia Avenue, Fort Pierce FL 34982 � Wc Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: Y2, v),, I PROPOSED INPROVEMENT LOCATION: I Address: Property Tax ID #: Site Plan Name: Project Name: Lot No. Block No. I DETAILED DESCRIPTION OF WORK: I 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 XRoof 5 1 1 Q- Pitch Total Sq. Ft of Construction: I -100 Sq. Ft. of First Floor: I ---I U0 Cost of Construction: $ 15� U-D -(DO Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Na - ' TT-JQ n rw if Name:--f i r)nnycl r(fl I o -HT Ad � Inr ess: fyx Company: I. -PD — citvjs� V 9 State: _E�_ Zip Code: Fax: Phone No. Address:m T�a P Cii l"rY CJ State:-E7L- Zip Code: 3 4-9 F? Fa Phone No -1 --) -c)- -3 -.?- ��H Sn E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail riCJQJrC01Lk+1-)QE;�lY)GlJ CZP� State or County License Q 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 INFORMATFON. DESIGNE ' R/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: 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.LucieCoun makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in co i7lict 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording vour Notice of Commencement. \/ (Wsy� lW5 ewvn� \) rinp 9-9 ,, I Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/LicensF-Holder STATE OF FLORIDASE STATE OF FLORIDA COUNTY OF I L4 COUNTYOF ��H I 4C Thhefc;rg�iingi tr twa acknowled before me mi In The forgoing instrument was acknowledge efore me �� this,pladayof A by this ay of by _d;L1_a 1 —1 2 1 cj;:;�2��Jrdich 1, � P i i�_ 13 1 rin K:J ro Name of person rn . aking S—ttement. 70R Nameof person mak7ings tement. Personally Kno. ... Produced Identification Personally Know.. OR Produced Identification Type of Identification Type of Identification Produced Produced ISM0 kure of ab—tariPublic- St tt�pf;Fllorida YATHERINE HAVENS a ortary Public- Stal e of.Fl ida ) KATHERINE HAVENS MY COMMISSION #GG1 65030 My COMMISSION #GG165030 Commission Ni (S&TJ ES: DEC 04. 2021 Commission Nqq;�:�)&fan I (SeMYES DEC 04. 2021 t rough Ist State Insurance L Bonded Ihnoug'h Ist State Insurance REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev.!I/Zb/18