HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- SCANNED
BY RFc`7�gn
St. Lucie County
COUNTYSFp r. S
- Building Permit Ap a iQFA. 0
Planning and Development Services neG e,�.4, OP
PFeko'
Building and Code Regulation Division / "r�
2300 Vrginla Avenue, Fort Pierce FL 34982
Commercial VVV Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 3200 KJ A - f) l 1 i C CLXJ :LJI 4:�L '2 o
Property Tax ID #: /4 7-5 - cbCYJ - 00 in�' - Ooo - S Lot No.
Site Plan Name: Block No.
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Project Name:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters / Windows/Doors
Electric _ Plumbing _ Sprinklers Generator _ Roof, Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1!41 opc-) Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ljeName: !�f e rU�6 �cJEai'e�
Address: G3 (z:r Company: 'Pce1 6)? Or roc o(0
City: i n State: F Address: 4 R S I IyUQ ?� Avg
'
Zip Code: 33)SCo Fax: City: Mi(:"tm State:-I�-
Phone No.r:;P�ra) 2b 8 -:66 -9: Zip Code: Fax:
E-Mail: 4 a a G ICE CAa . C'4yp Phone No 39 � 9
V
Fill in fee simple Title Holder on next -page ( if different E-Mail C (2 flea
from the Owner listed above) State or County License Z
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 requited.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
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
"YARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OFB SITE BEFORE THE FIRST IINSPECTIION. IF YQQ��COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE WIlTH YOUk LENpEROR AN ATTORNEY BEFORE RECORDING YOURINIa CE OF C,OMMENMMWD TO CEMENT."CING, CONSULT
Signature of Ow er/ Less/Contractor as Agent for Owner
Signature of t actor/License Holder
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The for g inst a as acknowledged before me
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Name of person making statement.
Name of person making statement.
Personally Known r OR Produced Identification
Personally Known OR Produced Identification
Type of Ide tifica ion
Produced FiL e���r���td6�
Type of Identification
Produced
(Signature of Notary Public- to o ttd'oYrfia) I MA3Ag4''0
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19