HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE''cu r'OR APPLICATION TO BE ACCEPTED
Date: �� 11� Permit Number: \INO- 0k6 S
SCANNED
BY RECEIVED
s St. Luriprhinih/
-- - — Building Permit Applicat on SEP 11 2019
Planning and Development Services
Building and Code Regulation Division SEEP
County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
112,00 POSED IMPROVEMENT LRMT10K
Aad' ess / O�J �o �nR (✓li2_
Pro perty-Tax-ID-# Lot No.
Site Plan Name: Block No. q
Project Name:
DETAILED DESCRIPTION OF WORK:
d— 40 i SZ. C-O
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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 _ Roof 'Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Gost.ofConsfruction;.$ ��`p�, Utilities: _Sewer _Septic Building Height:
OWN F RSSEE: CONTRACTOR:
Name&I A-S s Name:
Aldress:/c�S7dT� Mad, erwi T)AtP- Company_:
City: f�S L State: %GL Addre`ssi ` ,F
PIlp Code: % Fax: City:,- '- State:_
oneNo. Shy % O Zip Code - " 'Fax:
I
E=Mail: I QM t? 4 00 Phone No
— F
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) 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.
EER: Not
MORTGAGE COMPANY: Not
Name: Name:
Address: Address:
City: State: City:
Zip: Phone Zip: -
FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY:
Address: Address:
City: City:_
Zip: Phone: Zip:
_Not Applicable
OWNER/ CONTRACTOR AFFIDAVIT: 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 YOUR LENDER OR A AT' FORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
:Signature_o_f_Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF s k, 1 Oc
COUNTY OF
The forgoing instrument was acknowledgr� before me
The forgoing instrument was acknowledged before me
this�Xr day of �t-b ,20_ by
this day of 20_ by
Name of person making statetnent.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known _ OR Produced Identification
Type of IdentifiS�Sion
Type of Identification
Produced [ L t) L_
Produced
(Signature of Notary blic-State of Florida ignature of Notary Public State of Florida)
AUINE GNENS _.
' �� D�Fg510N»�., pY2p23 -
Commission No. oa ( gppp mmission No. (Seal)
£ jftU ,
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EXPIRES'.'IS
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tlu� Na�arl� . ,
.d; .t•'07
REVIEWS FRONT ING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ,
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19