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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 ��ryry 99 -` F Date: October 18, 2019 SCANNED Permit Numbe • /C _D- 0, BY - a— Sf. Lucie County • �_____ Building Permit Applic tion OCT 18 2019 Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie Count F 2300 Virginia Avenue, Fort Pierce FL 34982 County, L Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMITTYPE: Fv e) +a-) PROPOSED IM,PIOUEMENT LOCATION::- Address: 38WSelvitz Rd , Ft Pierce, Florida Q Property Tax ID #: opt - - COO-7- QOQ- 9. Lot No. Site Plan Name: rylpbi Block No. Project Name: iC li 061i P_ Additional work to be performed under this permit- check all that apply: _Mechanical Y[Gas Tank AGas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ -� 009- O ell) Utilities: —Sewer _Septic Building Height: OV11NEeR/I£EE`' A ! .a m CONFRfiG7OR: j ? ' Name i- L Name: -Vrm QA-, rS Address:aS-C 11.7PC4 IIoA- 1'(- Company,' Address: a3 a cAh City: WESd qc" NLik State: Pi Zip Code: 3) t{. L 3 Fax: 11' Phone No. City: Y Zip Code: 32-e Phone No 83-5 -YI14- State:Pt _ Fax:rzol-35-tC A10 k�.i E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail — 0%2i CO N+ Stat r County LicenseAL &VD1 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. S t�PF M£N �A£C©1 itUGflOC1 L EIt W'TPIF RM ndk « x" ._.:.�'rr.^?',e.. r.., u .r _o-�`..c`xp _.v,� `2 'w E �.Ck✓'`a; Si- z _.. t_?,Sdt;.: ,t x :. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: � f /YLcfr ( Name: Address:`(-7� Zii(,/i!2/'t�— Address: City: O %P'i h r,t� an St�� City: State: Zip: n-7 I S r- Phone 9 — •F 77/ Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: 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 COMMFNCFMFNT" C"'" ig rtafdF�wP ner Lesse�ctoras W'� / / g�for'Owner T Si�rj�tnre oLCrontractor/Lic , �lotd' STATE OF FLORIDA STATE OF FLORID - COUNTY OF //i�U COUNTY OF The forgoing instrument was acknowledged before me N The fo ing instruiEnen was acknowledged before me 7iday �' this day of (4 G� • 20jR by this of (_(� . 20e,q- by -rl r'nOng y Li I, 7 s 7 i Pi 4b u (5V �i» s- Name of person making statement. Name of person aking statement. / Personally Known OR Produced Identification Personally Keetyn OR Produced Identification Type of IdEin ifi a ' n e p X • ._ d ^ L Type of Identificll 'ion Produced Produced (C • , (Signature of Not y Public -State of Florida) (Signature of Not ry Public -State of Florida ) Commission N .•::�x?."'••. AUDREYB.F ryj�REY ..... ;7— Commission N •. AUDREY B. HU ';;; MYC MISSION#GG 3W817 COMMISSION # GG 300817 .mi:, EXPIRES: March 6,2023 REVIEWS tFRC91rli' "'•.i,�'F;f �: Bond Thru Notary Pubtre U raerwaors"'.,yfF;°•` = SUPERVISOR PLANS V �EiAP�6 71w NO Pubf ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED nCV. L///1v