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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONy. l All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� ©�h Date:. SCANNED Permit Number: 1 ` /0 T BY St. Lucie County 0.ECERIED Building Permit Application OCT os 2019 Planning and Development Services Building and Code Regulation Division Permitting. Department 2300 Virginia Avenue, Fort Pierce FL 34982 -' St. Lucie county Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential PERMIT TYPE: PROPOSED INPROVEMENT L ATION: Address: r Property Tax ID#:to �!S— 0 22-1 — 60h 0 Lot Nd'r / > /3) ) Site Plan Name: Block No. Project Name: DETAILED 'DESCRIPTION OF WORK::, �`X1.0 CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: Mechanical _Gas Tank _Gas Piping Shutters Windows/Doors j2Electric41-5-A W Plumbing _Sprinklers _Generator _Roof '' Pitch ,. p Total Sq. Ft of. Construction: Q f' Sq. Ft. of First Floor: Cost of Construction:,$ 1 Sol,O/7:. Utilities: :—Sewer -_Septic Building Height: /.5/t'_ OWNER/LESSEE: ,= �t CONTRACTOR: �:.. �n Name Q.N �1v�V�S�rv�i/�- LlG Name: Address: M"\-n'm QLZ Company: o City: C-OT-L\ Zip Code: ryy .) \A Fax: Phone No. Q^Q\- p 1k -�0�� State: FL- Addressv�c�l t ilc�. City: car • .� rCD Zip' Code: 3yrt6\ Phone No r7l;?.- State: -DNT E-Mail: - Fill in fee simple Title Holder on next page.(if different from the Owner listed above) .- E-Mail State orCoun4 License If value of construction is $2500 or more, a RECORDED Notice of Commencement is required._ If value:of FIVAC is $7,560 or more -,:a RECORDED Notice of Commencement is required. rii SUPPLEMENTAL CONSTRUCTION LIENLAW INFORMATION: DESIGNER/ENGINEER: Name: Cht'.Si-CL, �1.1a„ _ Not Applicable —&AW&oa\C MORTGAGE COMPANY: Name: _ Not Applicable Address: \ao k—�� Address: City: yr-State: Zip: Phone U n `1L City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: t/NotApplicable BONDING COMPANY: Name: ✓Not Applicable 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 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 posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording vour Notice of Commencement. SilgAture of Owner/ Les ee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA 1 ` COUNTY OF _S _ L\,Li� STATE OF FLORID COUNTY OF c� The foring instrument was acknowledged before me thi day of � 20_ by The forPoing instrument was acknowledged before me thiso74 day of S( O� 20_�q by c,.C, {')&f IC o -ec A Name of person making statement. Personally Known ✓/ OR Produced Identification Type of Identification Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced Produced (Signature of Notary Public- t�tt� ¢lori{f�a'bb Public State of Flodda �^fr� Trade L Lamb Commission No. CCG�� , Q01/2512 20 re63 ignature of Notary Public -St a rldyyblery Public State or Florid (^�l^ �! y1 Trade L Lamb mmission No .c c94'�Tjla3 �oQ rV 11 01/2mission FF e47863 or r� p1 01/25M020 REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED Rev.9/26/18