HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �//�I M
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Date: SCANNED Permit Number: 1IO—
BY '
St. Lucie County
� - RECF;1VEk14-;
-- - --- Building Permit Application OCT '612019 '
Planning and Development Services ftrnlltting Department
Building and Code Regulation Division St, Lucie County
2300 Virginia Avenue, Fort Pierce FL34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential !/
PERMIT TYPE:
PROPOSED IMPROVEMENT
LOCATION:
Address: 45bn6 /t'% — f
Property Tax ID#: O i' — �1�. 40070- 0091? Lot No. 1-7
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
_ G - 6 To Q �7
A04 A. - 6
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:' �YG�' dot
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
Electri _ Sprinklers _ Generator _ Roof Pitch
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Total Sq. Ft of Cons ruc Sq. Ft. of First Floor:
Cost of Construction: Utilities: Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 4.
Name:
Address: Q
Company: f
City: State: ^
Address:
City: State
Zip Code Fax:
Phone No. '72 , 3&/ �) 0 g2
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Zip Code:3 f rYS7 Fax:
E-Mail:
Phone No % Z - r —^ O
Fill in fee simple Title Holder on' ext page (if different
E-Mail 6
State or County License — 6 s.>'
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 $7,500 or more, a RECORDED Notice of Commencement is required.
PL R 00
DESIGNER/ENGIN
Name:
C• N 7R
ER:
0 E
_ Not Applicable
Fd&Z--FQS
O O
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 54
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Address:
City_:
Zip:
Phone 772E
State: f�
774=q&1e -
City: State:
Zip: ----- one: -
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name: /
Address:
Address: Il I
b
City:
City:
Zip:
Phone:
Zip: hone:
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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in cdnflict•wjth'anyappllca le Home.Owners Assocatioq rules, byla�'vs,or and coven0antsthat•may restrict or prohibit such
structure. PleasE•ponsult with your We Ownefs Association and review your deed for any r'Estrictiohs which -may apply.
In consideration of the granting of this requested permit, I do herdby,agreEtli'ai.l will, in'all respects, perform -the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
—1
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,F.INANCING, CONSULT
WITH•YOUR'LENDER DR AN ATTORNEY BEFORE RECORDINd•YOURIYOTICE:OF 40MMENCEMENT.,%�,
.Signature of Qwger/ ssee% tetra ras Agenti.for (YVJnet .:
- -
Sig ature,of`Cdn t6r/L`ice Hotde - �,'• -; �:,?.
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument -wag acknowledged before me
The forgoing instrument was acknowledged before me
this: + day of ,20_ by
this day 20_ by
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Name of person ma mg statement.
Name of person making statement:• 2,_
Personally Known OR Produced Identification
Personally Known OR uc Proded Identification
Type of Identification
Type of Identification
Produced
Produced
ig • tur to Public -State f Florida!) :. "t
ignat re of Noiary•Pub)i;. ate,of Florida ):
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