HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date: 3 SCANNED Permit Number:I�A -J q
BY
St. Lucie County
Building Permit Application
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:
LOCATION:
Address: '/& -/,S KLl.
Property Tax ID ##: 2/.�01
Site Plan Name:
Project Name: cA
AILED DESCRIPTION'. OF WORK:., ,._
CONSTRUCTION INFORMATION:
Commercial )— Residential
ra►�
7vlsJO/L«:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
1XElectric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction:$ /OA 305. Oa Utilities: _Sewer _Septic
I,
OCj232019
ST. Lucie County, Pern
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name o/
Name.
;
Address: &00 3rdJIPiW
Companyo
a+s,-,
City: Stater
Zip Code: Fax:
Phone No. 3 2/- AM- y449
Address:sl,3
/os•,e
City
Zip Code: 32/9,?3
Phone No 'fG/- P '%'J !9
State:
Fax: HG/. Q77�'
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail M i Y-z @ PP;a(e--e
Leg-` hi l . Coo,
State or County License EC
/ 30o - S95 9
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.
DESIGNER/ENGINEER: _ZNot Applicable MORTGAGE COMPANY: ,_(Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: `>t Not Applicable
Name: T
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Address:
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 _10" TE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBT/NN FINANCING, CONSULT
WITH YOUR LENDER/OR N ATTORNEY BEFORE RE[ORnnuir; Ynim NnrtrF nF rnM Nr MFmT n
o�
l
Sig66tfire of Owner/ L ssee/Contractor as Agent for Owner
Signat f Contractor/Licei se Holder
STATE OF / .,,,lL/
OF ORIDg�`�,I
OUNTYOFORIDA�.,(c
COUNTY OFSTATE
The fro' instrumennttPPw//a acknowledge efore me
this yof CJ/' 2n by
The f rgo�,ippg instrument was acknowledg d before me
this -r"�ayof hc*bef'"-/� 20 ° by
L'
�/ /yljC�l9CL ��1DL�
Name of person making ement.
Name of person making statement.
ststa
`
L�
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
R4-P__
I/h
(Signature of Notary Public- Sta ri TARYPUBUO
(Signature of Notary Public -State of Fl ida j Ana �
Commission Noff 7 Co 1 A
Commission No.Coffiniiii-WhO
KFLORIODA
Ims 1111312019
Q=M# FF84 M
res 11/13/201
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19