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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION/ �\ ( \ I 1 ©�/� SL �'( Veit �e&sbmM wW� (, All APPLICABLE � I/R INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t, 0 �{ Date: %/61�i` ! SCANNED Permit Number: BY St. Lucie County RECENED — Building Permit Application JUL 10 2019 Planning and Development Services Permitting ' Department St. Lucie County Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: 462-1553 Fax: 462-1578 Commercial Residential (/ (772) (772) PERMITTYPE: die �oaa tl PROPOSED IMPROVEMENT LOCCATION: Address: 1 61i,- Val, �J 3Y440 Property Tax ID #: LLA(u+ ht_" 0M'�4 Lot No. Site Plan Name: Block No. Project Name: c4,VL&A DETAILED DESCRIPTI W N OF ORK: rO,� G0'_fkjSo �. we 3 F,t "COMA Kc^k'.-tic )d"P. ered:�� t1cW S1,ow4r pan 1,L :1< Sv�ac..�r W-�v� wjM,Fifs 'tyi�LtS. CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _tzElectric Plumbing —Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ q '000 Utilities: +Sewer _Septic Building Height: ERVER TESSEE: CONTRACTOR: Name 1 L r kmu,n _ Name 41 0 L 7 2 Address: i7Hcl Lr7c:.,r M1 ; �i�t Company. City: NrUI 6fl- 1 ( State: Cam- Address Zip Code: Fax: " City: �Cti /cT .' :I :.•, Stater_ Phone No. Zip Code: 34441 Fax;2. E-Mail: abrlgD �040;v.•. Phone No - Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License (r GG iu J 3 0 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. C s*` SMHEMENTA CONSTRUCTIO LA N"RIM, DESIGNER/ENGINEER: _ Not Applicable Name: ON: 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." Signature of O er/ essee/Contra or as Agent for Owner Signature of Co ract License Holder STATE OF FLORIDA STATE OF LORIDA 1 COUNTY OF COUNTY OF I— The forgoing instrum w s knowledged efore me was sa owledge before me Thefgoingins nWe this _a day of 20��by this day of 20�y Name of person ma tg statement. Name of person ma �' g statement. Personally Kno n OR Produce dentification Personally Kn n OR Produced Ide ification Type of Ide rfication Type of Ide rficatigp .' Produce 10-uJL, Produc �,(j�� (Signature of Notary lic- State of Florida) (Signature of NotaryPublic- State of Florida) ' Commission No. „ ELLEN VAUGHN Commiss „ EttE—N VAUGM State of FloridaFlorida-Noiary Pu is io"" z.=State of Florida -Notary Public REVIEWS - ?'s �a'g DRUM. Y�,pin}pissi n Exppu�es SltlPERVIS R PLANS %+ �.�c My Co w�°jATION00 mission Expires KU „ ;o or.2 , o55A2 . ANGROVE REVIEW EVIEW DATE RECEIVED DATE COMPLETED ev. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: t/ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: __I[ 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 any applicable Home Owners Association rules, bylaws or andcovenantsthat 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." Si ature of Ow er/ Lessee/Contracto s Agent for Owneri'gnat a of Con clot/Lice Ider FLORIDA E OF FLORIDA COUNTY OF 5k-L1Uc.\ COUNTY OF k,Ltic�si The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me 3fj thisdayofaXdayof �J� \T 20-qby t ��'2Zd�,'6 n\n 9\2.0}kd Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced V-%, AL_ Produced �L �41— '(Signature (Signature of Notaryublic-State of Florida) _^" •' of Nacic:D¢SaY�b}�r Commission No .G&O�+ D nd'd � .✓�"''..`�„'oV., MY �D+A S.D�y2r, •. �.. �:oy;y.+" `>>..at2:oA Bo ° REVIEWS FRONT G e° ISOR PLANS V GETATION SEATURTLE MANGROVE COUNTER RE)/1 REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.