HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 \�`1� Permit Number:
SCANNED
BY RECEIVED
St. Lucie County
' Building Permit Applic tionNOV 19 2019
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: Q U b
PROPOSED'INIpROVE(NENTrLOC u. AY^ Idt i �i-Q1-: • ur;i .Cv:. YfY.M' �.. ..
Address: 5039 AMY LANE FORT PIERCE FL34946
1 U �1 —��1 _ oW(n — llm Lot No.
Property Tax ID #:
Site Plan Name: Block No.
Project Name:
-
DE'TA LED DES&RI&IONOF;WORKf ,, '.1' 'MaG7�`1�i?r
r
ION§INFORMATION;,..f�
GORUG
Additional work to be performed under this permit -check all that apply:
_Mechanical asTank _Gas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator —Roof Pitch
Total Sq. Ft of Construction! Sq. Ft. of First Floor:
as
Cost of Construction: $ �BQ Utilities: —Sewer _ Septic Building Height:
a ; , 'CONTRACTOR
0 NERI�ESS_EEsa4 a. ,� ; w, 1, .,A.. Suttaa to s =
,W
S>) Name: e n cs cJ ca ei J !^
Name
Address: 0% CDI,�,f CiO� - Company: wAt `rh nGot
T-t l M,�f- State: L Address: 5o1 U CS Lcwu re� I ec `-e� -
City: d tj&L( iftJ2
Zip Code: �J Fax: City: S 04 el Stater
'`oZ)�(- %q� Zip Code: 3 2 7-J r` Fax:
Phone No.
E-Mail: �� rA iJ&P_ 04COM LISr• Vr } Phone No
Fill in fee simple Title Holder on next page (if different E-Mail m9n ez` m "ca ` `�
from the Owner listed above) State or County License G c / v�� s del
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.
7A
UPPLEMENTAL COPISTRUGTION l l NtIAUVaINFO`RIbIATON-
YiLn6ERMis!'b'
DESIGNER/ENGINEER: _ No pplicable
Name:
MORTGAGE COMPANY: _ of Applicable
Name:
Address:
Address:
City: State: _
Zip; Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE H DER: _ Not Applicable
Name:
BONDING COMPA : _Not Applicable
Name:
Address:_
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to ob&in 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 1 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
POSTfB\ON THE JOP SITEyBEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN. FINANCING, CONSULT
as Agent for Owner I Signature of Contractor/License Holder
STiTI a OF FLO IDA STATE OF FLORIDA r
COUNTY OF I 1�W CA,(-d COUNTY OF Vvt r HJ4
The for aing rnstr a was cknowledge before me The forgoing instrunot was acknowledged before me
this f lld`ay of Ill ( 20� by this � day of hJ . 20A by
?u�, �r�n Omic hLA IL _ � p
Name making statement. Name of person making state ent.
Personally Known _�\.OR Produced Identification Personally Known
Type of Identification Type of Identifical
Notary
Commission No.
N6MMIS5;0N N GO
IRES:Au9us1 r,l
Bonded Tl`vu N.A vf%-..:W
rk"
OR Produced Identification V—
REVIEWS FRONT I ZONING SUPERVISOR I PLANS I VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW I REVIEW I REVIEW
Notary Public - State I orida
a l�ommission rE GG 0 79
4y Comm. Expires Jun 2 2020
MANGROVE
REVIEW