HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COmNLETED FOR APPLICATION TO BE ACCEPT.,
Date: 00" Z -2 j Permit Number:
SCANNED
Esc; BY RECEIVED
St. Lucie County
Building Permit Applicatio 1 MAY 2 9 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 _�D
PERMIT TYPE:
PROPOSED WPROVEMENT LOCATION:'
Address: 'Uf) N. 39ir)'6t- Pca 6Pa2PA_314ol.147
Property Tax ID #: oZl-iDS14'aj _ (mLQc_ Lot No.
Site Plan Name: Block No.
Project Name:
Additional work to be performed under this permit- check all that apply:
Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost o�0onstricr'io -1 ��� o
r
Gas Piping
_ Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor:
—Windows/Doors
Roof 11"d, Pitch
Utilities: _Sewer _Septic Building Height: _1 �5
lJWNER%LESSEEM t;
CONTRACTOR,
}
Name:jose A- Kn.rP. rl %Ae A dt7-0-
Name- n /Q
Address: �Qjp k,i, Jim 6+-
Company:
City: FDC-ir Pit-'CcP. State:'CL
Zip Code: 3LA q-1 Fpax:
Phone_ x" , . e1
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
It value of construction is 52500 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.
Addi
City:
Zip:.
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: P e:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING
Name:
Address:
0.2
Not Applicable
_Not Applicable
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
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YdiUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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-
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The for oing instrument was acknowledge efore me
thim ay �w� 201by
The forgoing instrument was acknowledged before me
day
of
this _ of 20_ by
Name of person making statem nt.
Name of person making statement.
/
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identif'eatr6n
Type of Identification
Produced L
Produced
(Signature of Notary Pu
(Signature of Notary Public- State of Florida )
KAREN S. NIELSEN .
Commission No. ° :stale �f Flp,ida-Notary Public
k GG 217484
Commission No. (Seal)
- •= ComiT1F$5✓on
-?c My Commissi pires
%�0f June 12,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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[DATEECEIVED
ATE
OMPLETED
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