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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr^ } All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED SCANWD Permit Numt ° a.LuBY decouw Building Permit Appli Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982;,, Phone: (772) 462-1S53 Fax: (772) 462-1578 Commercial PERMITTYPE: yte�-? f 0A.;f-; r-n ��i 19n 7 ° I . r� \ice JUL '-8.2019 916YMitting Department ,St. Lucie County, FL Residential Address: C:z;-m `( C::, 1 Property Tax ID#: t410�o2,0,3430'009 Lot No. -43 Site Plan Name: OCEA►1 2,020ex S Co-'0 Q Block No. Project Name: 1,0-r 'R 9,3 ©GE�11'ro �b2- ems CO-�Q Additional work to be performed under this permit - check all that apply: ?Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors Electric _ Plumbing _pp��Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: ,aZge, l Sq. Ft. of First Floor: toz nE6!;� - mp r Cost of Construction: $ Ale Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name MQ(6 am-' ulneL Name: Address: b Company: City: `Q State: Zip Code: 3IV? Cf Fax: Phone No. f E07) 34 q 34S 7 Address:_ City: :,I a tr" "' ' ^='" State:_ Zip Code: -.,:Fax: Phone No E,Mail: Fill in fee si ple Title Holder on next page ( if different from the Owner listed above) E-Mail Statexr County License If value of construction is S2S00 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,S00 or more, a RECORDED Notice of Commencement is required. U LEMENTA'�UCTIO L[ NFO A 0 DESIGNER/ENGINEER:, -,. ; -;= Name:{ 8 is 114 Not Applicable 19 MORTGAGE COMPA Y: Name: _ NotApplicable Address 707 (di6D 7TL&A" 9Z . Address: City: r Zip: Phone SS- l ';City; Zip: Phone: State: (1' FEE SIMPLE TITLEHOLDER: '_Not Name: ,L' ' ' I Applicable BONDING COMPANY: Name: _Not Applicable Address: AA Address: City: City: Zip: Phone: Zip: P one: 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.l 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 rion=Eesidential 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 YOUR LENDER OR AN ATTORNEY BEFORE'. ECORDING YOUR'NOTICE OF COMMENCEMENT.". - Signatu a er sse r as Age6tfor Owner �'Signature of Contractor/License Holder - STATE OF FLORIDJ� STATE OF FLORIDA COUNTYOF 7 foi COUNTY OF The f ing inst nt was acknowledge before me The forgoing instrument was acknowledged before me this day of 20 by this day of , 20_ by M) cP 1 �'�l e_c 4 A) e �. Name of person making statement. Name of person making statement. Personally K OR Produced Identifcation—,"� Personally Known .. OR.produced Identification Type of Identifica Type of Identification Produced Produced (Signature of Not' Public- State of Floridan U (Signature of Notary Public- State'of Florida ) Commission N ..••.••"•`' ^"'�At10REY9 H MPHREY Commission No. i}(Seal) '. COMMISSION # GG 3M REVIEWS V lic *U B VISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVI EW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19