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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Q A'M(o •1 I o ` n�s Date: ` SCANNED Permit Number. I 1 P - BY RECEIVED St. Lucie Counts goy SEP 2 6 2019 -� Building Permit Applicatio 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: tc'-,00 00©r M 6V1,-1aL PROPOi E DI I M P. 50YE M E LIM LOCATION: �T - Address: -7 31 S V f l h wo -1 a p S °D %5 ._ S U,S:_H ,� Property Tax ID #: 3 11 I y S0I - I i 3:50 Lot No. Site Plan Name: Block No. Project Name: D AILED DESCRIPTION OF WORK: La C 0 111 YV\ e r c- �] e4,n lCr o rv� P CONSTRUC�TtON INFORMATION: Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank I - - _ Gas Piping _Shutters _ Windows/Doors _ Electric _ Pluinbink' _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 00Utilities: _Sewer _Septic Building Height: OWNE��22R/LESSEE: CONTRACTOR: Name: �C -B Name fJe Address: v _ Company: 1 na L,;L � City:TG/1�S7i�/L'' un State: 1 1,, Zip Code: �hS% 'Fax: 1 I Addre City: �Or i • ScFa. L VCf A �C- .J ,Phone No. state: Zip Code: Y / cS �� Fax r— E-Will"""„ Phone No 77 2.';S- ,_. Fill in fee simple Title Holder on next page ( if different E-Maih a v nnvi Q E�IJro t Yf 0 State or County Licen e ' (3 C 1 411 Ll 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. SUPPLEMIllENTAL CONSTRUCTIO LIE LA DESIGNER/ENGINEER: _ Not Applicable Name: FO TION: 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." Nrl h f � 6 -0 6 6- oi �n k I� 6 "i - , - - Agent for Owner Signat of 0 n r/ Lessee ontrU:212. Signatur f Con ra for/License Holde STATE F FLORIDA STATE O FLORMA 1 COUNTY OF COUNTY OF ` v The forgoing instr�ent-w s acknowledge before me this_ day of �Ph� .20` by AV �P,�r\ITIJ V The fgr oing instr ment this�L dayof201 V Aennv as acknowledgeAbefore me by Name o erson making statement. / Name of pers n making stateme t. Personally Known OR Produced Identification v Personally Known OR Produced Identification Type of Iden ' ' ation Type of Identif o Produced Produced��� (Signature of Notary blic- State of lor'd (Signature of Notary(Signature of Notary P& KAREN S. NIF_LSEN Commission ono"s+=�'�., loritla-N Public _ " waaV1 a Commission # GG 207484 Sion Expires Commission No. „96 , KAREN S. NIELSEN =�° lac State of(Sea -Notary Public =• •e Commission # GG 207484 8a -,;zo„o; My Commission Expires '�„°,;,;``°` une 12, 2022 une REVIEWS VISOR PLANS VEGETATIO COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. 21 r/ 19