HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED LI p1
Date: 1L� �y� Permit Number:
SCANNED
BY RECEIVED
—� ----� Buik4�gi iit Applicat on SEP 2 4 7019
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
PERMIT TYPE:
PR • POSHD MPROUEM�ENT LOCA ION:
Address: JC2/dD3,
Property Tax ID #: -Gt7 O - Lot No.�
Site Plan Name: Z L Block No.
Project Name:
7ETAILED UESGRIPTION O WORK:
INFORMATIO CON5TRUGTiON N:
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:
Cost of Construction: $ '�(�(i �- Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: ,
'
Name . t 7—Name:
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Company:
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y: .,- •- L, State:
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Zip Code: 3 �FQi4`P : -s -?Fax:."' �-
Phone N'o:'gsi`
Address: IaSl7�iS'`_:YTCJftac q-^
t :,f J7 �8 r_u_�r.^.�V'� r; . i'.
City: 1rV� .} State
Zip Code:
Phone No 7FS(a.587• 9 9-S'
E-Mail: vOc (lp JJJL
Fill in fee simple Title Holder on next page (if different
E-Mail Gl
r 197mq) 11,
State or County License C GC (Sb Ibz7! L_
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,506 or more, a RECORDED Notice of Commencement is required.
SUPP EM � TA CONSTR
CTIO L P W
FOR TON:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
-
Address:
City: _
Zip: Phone - -
State:
- - - - - - --Zip:.
City: State:
Rhone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 thepermit 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 fromundergoing 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_"
Signatu Contractor/License Holder
Si ature of Owner/ Lessee/Contractor as Agent for Owner
r
a of
STATE OF FLORIDA,
[Ucic?
STATE OF FLORID '
COUNTY OF S.
COUNTY OF �. �cf��G
The forgoing instrume as acknowledged before me
The forgoing instrume was acknowledged before me
this 1'day of — /CltY! — 20117 by
this /!4 day of /— f�1�, 20,Lf by
Name of person making statement.
Name of person making statement.
Personally Known _V," OR Produced Identification
Personally Known _t/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produ
(SigntureWREVI
Signature of Not i
Public d FIaW
N " Sub d Floods -
Do�eltlJetq
CommissioG3dt�l)
Commission No. • 7001
8
.. M i,.. F.xplree 0713U2023
REVIEWSING
SUPERVISOR
PLANS
VEGETATION' '
SEATURTLE
MANGROVE
EW
REVIEW
VIDATE
RECEIVEDDATE
COMPLETED
Kev. 21 i/ 0