HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7,1 Iq Permit Number:
ar(i�
SCAMNEU RECEIVED
St. Lucie Comb JUL 05 2019 _— -- ---- Building Permit Applicatio
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: f5Ot�i1.�C—(
PROPOSED IMPROVEMENT LOCATION.:;
Address:
Property Tax ID #: Lot No.
Site Plan Name: GoAh'>A,-L COVES - U hJ 17 I - L- oT G1 Block No.
Project Name: i-(T71-1e,4LA-LA3 -rl V-1 0-0-T
DETAILED DESCRIPTION 'OF WORK;
G0146TiZ (JT -niz-1 lam.) F 6Ur-1L
`�9C1hTI AEI DdclL
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction: t 7-0
Cost of Construction: $ Wyl. �®
Gas Piping
Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
.OWNER/LESSEE:-, ." _
CONTRACTOR:.
Name `! �y1 N ITZCC,
Name:
Address: a 1 4
Company:
City: (-�r 14 1IGi LA-iJ D State: IFL'
Zip Code: �l&1 `%S Fax:
Phone No, 6& I - -(1 fti -.7-14 a- I
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: EIl a 661 �0— t.Eiq
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
IT value or construction is s2500 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.
SUPPLEMENTALCONSTRUCT LIEN LAW INFORMATION:-, F..;
DESIGNER/E GINEER:
Name: \�JAA"h
_ Not Applicable
MORTGAGE COMPANY:
Name:
\/ Not Applicable
Address: 47S5
AA/�-
Address:
City: -tJ0& 1* ?o• --x-
Zip: Phone g_4i
State:
— 5r,q--(0.4 1
City:
Zip: - Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
✓ Not Applicable
BONDING COMPANY:
Name:
,/Not Applicable
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. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co Count 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 anothermon,-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 YnrfR r FmnFR no AM AVMRnsEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signat re of Owner/ Les e otract r as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The f oing instrVerIt was acknowledge before me
The forgoing instrument was acknowledged before me
20_ by
this dayof J\11N 2014 by
this_dayof
1 l_
Name of person making stateiiAent.
Name of person making statement.
Personally Known OR Produced Identification V/
Personally Known . OR Produced Identification
Type of Identificat' A
Type of Identification
Produced
1
Produced
(Sign tune of Notary Public -State of Florida)
(Signature of Notary Public- State, of Florida )
Commission No. o,, EN S. NIELSEN
•�e'-State
mmission No. (Seal)
of Florida -Notary Pub
is i
° •E Commission # GG 9074P
y mmission Expire
REVIEWS
FRONT
LANS
VEGETATION
SEATURTLE
MANGROVE
REVIEW REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
,O 1
RECEIVED
DATE
COMPLETED
Rev. 2/i/19