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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p �} Date: �lT� SCANNED Permit Number: `1dvo7��v I BY OCT 19 2019 St. Lucie County Permitting Department St. Lucie County Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, -Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential PERMITTYPE: L ► r" Address: Property Tax ID �fll ./n(�'7C7��-�C7� Lot No. Site Plan Name: Block No. Project Name: Additional work to be performed under this permit- check all that apply: Mechanical Electric Gas Tank Plumbing Total Sq. Ft of Construction: Cost of Constr —Gas Piping Sprinklers Shutters Generator Sq. Ft. of First Floor:_ Utilities: _Sewer _Septic Windows/Doors _ Roof Pitch Building Height: OWNER/LESSEE: CONTRACTOR. ame R--A-sK-1R-�eS Name: Address: %80? 154n;rA-i 61-- Company: ity: N� 14�E State: !_f- c3V7Sr Fax: �tneNa�7'Z 32-1-3 i3: Address;Code: City: :-i, State:_ 5. Zfp Code; Fax. . E-Mail:i' f-QV2Zlf3wi1.- �f'f�I in fee simple Title Holder on next page ( if different om the Owner listed above) t� E-Mail State or County License If Value of construction is 52500 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. UPPLEMENTALGONST M WON: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone------ City: State: -Zip: Phone - FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: 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 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." " `I , Signature of Owner/ e C ractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA \ COUNTY OF COUNTY OF The for ��m�� instrument was cknowledged before me The forgoing instrument was acknowledged before me this Tda� of �, 20Aby hurt ink 1) v rn p 13 this day of 20 by Name of person making stateme^ Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced ldentification Type of Identification az Type of Identification Produced C� VO_A 1 Produced U (Signature of Notary Public ate of Florida) (Signature of Notary Public- State of Florida ) Commission No.L(E �i/ a Commission No. (Seal) as ate of F on Notary Public y •; Commission # GG 270079 °"%��`"�` October 2, A22 _ REVIEWS F PLANS VEGETATION SEA TURTLE MANGROVES COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ' COMPLETED Rev.2/7/19 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: , Not Applicable Name: Name: Address: Address: City: State: _ City: State: Zip: Phone _ Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: 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 the permit holder to build the subject structure which is in conflict with Home any applicable 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Ov ner L se / ontractoras Agent for Owner Sigg ture of Contractor/License Holder STATE OF FLO /{ STATE OF FLORID,�/� COUNTY OF +•� 1VC.I P /� COUNTY OF f LCIr Vl' The:fpfgoing instru------mrrree''''''n''''''t��l��lw''''''as acknowledgg efore me this day of 20 by The f r oing fhstru �e�n�,t�.as�a_ck�no�wwl�edged before me this dayof1--7--- �Q.by L' 7 ucneS Name of person making stat ment. Name of person making statement. Personally Known OR Produced Identification L Personally Known OR Produced ldentificatiov Type ofldentific�tt�n Produced \— L 1i L_ Type ofldentiicati n Produced I I (� - spy WithmY S• ,leanbaptiste ICI (Sign lure of Notary Public- State df ie NOTARYP Commission No. �r Floridal STATE OF �- - Comm# FF J 0 Rif -PHBL16•— 0&natur c No a Public- } TE OF it BLIC — z ; GG105923 LC�bssion o. Q� CE 19� 21p res 511712021 7381 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE. COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.