HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE (INFO MUST BE
Date: Permit Num e .BEE COMPLETED FOR APPLICATION TO BE ACCEPTED
/ • � . ! -/
SCANNED IRECEIVED
a"Jic1l�' a BY
St. Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Address:
Building Permit Appli ation JUL 26 2019
Permitting Department
St. Lucie County, FL
Commercial Residential
Property Tax ID #: I BIZ— �\ —o!)3 to OW— Lot No.
Cif. Pl.n M.M.- Rlnrle Kin
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: �/ o �k Sq. Ft. of First Floor: _
Cost of Construction: $ d` Utilities: _ Sewer _ Septic
Windows/Doors
Roof Pitch
Building Height:
k 2- ad°
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CONTRACTf?R<
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Company:
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City:
State:
Zip Code: d Fax:
Phone No.
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Phone No_S0,-
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E-Mail:
Fill in fee simple Title Holder on next page ( if different
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State oounty License
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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.
SUPPL�'I CNTA(CONSTRUCTION LIEN LAW INFORMATI"
DESIGNE N INEER
Name: W `
_ N Applicab1l�n
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MORTGAGE C M NY:
Name:
Not Applicable
Addre s:
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Address:
City:
Zip: Phone
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City:
Zip: hone
State: _
FEE SIMPLE TIT'
Name: 71
Address:
City:
Zip:
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Not Applicable
BONDING COMPANY:1 fNot
Name:
Applicable
Address:
City:
on
Zip: hon
OWNER CONTRACTOR FFI IT: A lication 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 LENDAR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Si ature of Owner/ Lessee/Cont actor as Age?Vf for Owner
Signature of Contractor icens er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF'2-nj;co R;y1q,L
COUNTY OF �'jf`£yAr
The forgoing instrument was acknowledged before me
The for gqiIng instrument was acknowledged before me
this�dayof .TvV1P .201nt by
thisMayof J d I y .20(J by
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4. R E, I I Lr
Name of person making statement.
Name of person making statement.' •-
Personally Known OR Produced Identification✓
Personally Known OR Produced Identification
Type of dentification
Type of Identification
Produced
Produced ~w� KATIEFiART
Notary Public -State o}
Commisslon ,s GG 04
MY COMM. �t�lalla
Feb.
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(Signature of NdtAry Pub •
L DEANNE GRIFF
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ignature of Notary Public -State of, lurid
�,a`M.o�.,
Commission No.� ( 4,s State of FFlorida-Notery Pub
- Ccir$RfilAsion # GG 11884
is
mmission No. (Seal)
?y g° M Commission Ex fires
�OnSi��� y
June 28, 2021p
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