HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Co 6
SCANNED'
BY RECEIVED
1- mire"T44 St. Lucie County
Building Permit Application MAY 2 8 2019
Planning and Development Services ST. 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
PERMITTYPE: liIt�N
Address:-6�-//
I
Property Tax ID #: 0 Lot N a. 3 66'
Site Plan Name: AeV4� //C?- F- Block No.
Project Name:
Additional work to be performed under this permit— check all that apply:
—Mechanical GasTank —Gas Piping Shutters —Windows/Doors
— Electric — Plumbing — Sprinklers — Generator — Roof ' , Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ krss� Utilities: —Sevver _Septic Building Height:
[00 11 E R!/A 0 E S S E
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Name
Name: enet;1105e
Address:,J'/// /C?94,,eT77-0
Company:
City: q�;�dx- State: J�
Zip Code: 5�� Fax:
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Address:
City: State:—
Zip Code: Fax:
Phone No
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Fill in fee simple Title Holder on next page ( if 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.
tSOPP.LlEK4ENiT�A'LI[CoON-SiTiRW-C"rilONILlIENILM'WIIN-.,RMAiTils
DESIGNERTE—NGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applica'ble
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:
Zi P: 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
POSTE� 0 JOA-99,FBEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y =RW oR-AW'"TORNEY 13EFORE RECORDING YOUR NOTICE OF COMMENCEMENT2'
Signature of Owner/ Lerse—e/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUN��.
COUNTY OF
OF
The forgoing instrument was acknowledged before me
The 10 oing instrument was acknowledgii before me
this _ day of . 20 by
this .1.4 day of 20_ by
VNO�P%T-k
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identific i
Produced L
(Signature of Notary Public- State of Florida
Commission No. (Seal)
(Signature of Notary Mblic- State of WxeGWV1VLzj 11
D S10144GG0 20
Commission No. We
, anacember A6.20 rgfovs
EX?
Bonded
REVIEWS
FRON
ZONING
SUPERVISOR
PLANS
VEGETATION
S EA TU RTL E
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2/7/19