HomeMy WebLinkAboutBUILDING PERMIT APPLICATION>. r
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�.1t / 1 1
Date: lU�ad�iry Permit Number: 1 - \ IO - l J l0 I i }
RECEIVED
�- -- B� Iding Permit Applicati OCT 2 8 2019
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MAC NI -D ST. Lucie County, Permitting
Planning and Development Services BY
I Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Count
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
PROPOSE IMPRO - IENT OCA ION. l e
Address: ,Z 6G /'/crr/nq 0, l0,4 POrce. FG .3$94'7
Property Tax ID #: 141I5:- 701-0 I.x) "GOG - a- Lot No. /a
Site Plan Name: Coro,! Cove ''� f, Block No.
Project Name: r /t�C/� `ence
DETAILED DRSCRIPTION OF WORK:
.rA er+oe balCA7 lAOLrC4 CAIC'! 6'1 > sr// c a,%norl -ride-.
rli'GG /7 Ac .rA4& 01174 ntr{ I
CONSTRUCTION INFORMA ION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors •.L
_ Electric _ Plumbing _ Sprinklers _ Generator %Roof 'Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ )-000 Utilities: _Sewer _Septic Building Height:
OWN R/LES-SEE:
COT LTOR:
Name XP64,fa /C!e tl
Name:
Address: d.60 r lar"10,
`
City: FOrP Ir/,erce, State- 'FL
Address:
City:, State:_
Zip Code: 3'r911y Fax:
Phone No. 77� 37C/ 6 fe0/ -
Zip Code: Fax:
E-Mail: r•rleoirfAlYJ1Ec I'lav%5.00--1
Phone No ro
Fill in fee simple Title Holder on next page (if different
E-Mail
State or County License
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. '
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DESIGNER/ENGINEER:
Name:
O
_ Not Applicable
MORTGAGE COMPANY: _ Not;Applicable
Name:
Address:
Address:
City:
_Zip* —hone
State:
City: State:
_Zip_ Phone:
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 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, C�1,1f115ULT
WITH YOUR LENDER'GR AN ATTORNEY'BEFORE'RECORDING'YOUR NOTICE OF COMMENCEMENT. I `
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORI
STATE OF FLORIDA
COUNTYOF �_ 11C(t,
COUNTY OF
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The forgoing inst as acknowledge efore me
day by
The forgoing instrument was acknowledged before me
day by
this of 20JII
this _ of 20
�1�,�141�(I� TYIP�I2.1C'A�.
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identi�+eation
Type of Identification
Produced it L IN
Produced
(Signature of Notary Pu ic- t
ure of Notary Public -State of,Florida )
KAREN S. NIEL
EN
Commission No.
, a of Florida•Notar
Nmmission A GG 2
P�ub'c
T4�
ssion No. (Seal)
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ow; My commission Ex
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