HomeMy WebLinkAboutBuilding Permit Application Feb 04 2019 10:31AM HP Fax page 3
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All APPLICABLE INFO 1,,ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number: [CIO)-. (A I-.")
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Building Permit Application
Planning and Developni It Services• 0
Building and Code Regal. on Divisi ri 0
2300 Virginia Avenue, .1 Pierce .361982 il
Phone: (772)462-155 I Fax: (772)462-1578 Commercial Residential
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PERMIT TYPE: Hi r
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PropertyTax 10#: -3, I 8 — 000 ''' -.? Lot No.
Site Plan Name: Block No.I
Project Name: I'
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Additional work to be p J.rmed nder this permit-check all that apply: i\
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Le-Mechanical Gas T.nk Gas Piping Shutters • Windows/Doors
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Electric Plum',ing _Sprinklers Generator Roof Pitch
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Total Sq. Ft of Construct)I: • I Sq. Ft.of First Floor:
Cost of Construction:$ Y•-_,3 . • • b s" Utilities: _Sewer _Septic • Building Height:
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Name AVgIONIIIIIIM Name: 0 , 4r- ..1 treu- )V ik 5
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Address: •- 93'> lie tv . c.,„1 r Company: 4 , f 6e.t.v77.4 1,
City: . • Y :.. i e.._ I State:.0 Address:.....s-r As-- si. i tkir t) 01k Pr
Zip Code: ..4,v..S.2. Ill Fax: State:Li \\
City: Fne+ pi etc..'- '
Phone No. 3 a — Ili 6' Zip Code: 3 y 1 fi"P ,- Fax: 211 41.60- 6qii
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from the Owner listed ': .ove) State or County License t '/1C /EN.c0,Q
•If value of construction is$ -00 or m,re,a RECORDED Notice of Commencement is required.
If value of HVAC is$7;500:. ore,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINE. '4I _Not Applicable MORTGAGE COMPA' Y: ___Not Applicable
Name: i11
Name:
Address: I Address:
City: !i State: City: State:
Zip: P ' e Zip: Pho e:
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FEE SIMPLE TITLE aft,
'ER: j� Not Applicable BONDING COMPAN . Not Applicable
Name: I I Narne:•
Address: IIIA Address:
City: III City;
Zip: Ph(: e:_,-1 Zip: Pho
OWNER/CONTRACT! ' AFFID IT:Application is hereby made to obtain a permit to d• the work and installation as indicated.
I certify that no work or int. 'Harlon as commenced prior to the issuance of a permit.
St.Lucie County makes no presents ion that is granting a permit will authorize the permit older to build the subject structure
which is in conflict with an, r•• Home Owners Association rules,bylaws or and coven-nts that may restrict or prohibit such
structure_Please consult '' h your H me Owners Association and review your deed for any strictions which may apply.
In consideration of the gra j ng of thi requested permit, I do hereby agree that I will,in all :spects,perform the work
in accordance with the act;I •ved pia ,the Florida Building Codes and St.Lucie County Arne dments.
The following building pe applica ions are exempt from undergoing a full concurrency r- 'ew:room additions,
accessory structures,swi ing pool ,fences,walls,signs,screen rooms and accessory uses a another non-residential use
WARNING TO OWNE'' our failure to Record a Notice of Commencement may r ult in your paying twice for
improvements to you I .roperty.A Notice of Commencement must be record•d and posted on the jobsite
before the first inspe � t.n. If you intend to obtain financing,consult with lend-r or an attorney before
commencing work or i- ordingiyour Notice of Commencement.
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Signature of Owner/Less-':/Contra or as Agent for Owner Signature of Contractor/ ense Holder
STATE OF FLORIDA : • ' I STATE OF FLORIDA
COUNTY OF „it! L tri 1 d,. COUNTY OF s r ) A t�.
The forgoing instrum-nt ��'--s ackno ledged before me The forgoing instrume t as acknowledged before me
this VA day of a *it, r' 1 20/1 by this„WA day of .. -a 201 S by
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Name of person making:-€ :tement. I Name of person makings atement.
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Personally Known OR Produced Identification Personally Known X OR Produced Identification _
Type•f Identification I Type of Identification
._ Produc-• _.-.. _. •
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(Sig r-. �.. •�_: ._. ). (Signa{
Commission No. Z./ It ,, I
(Seal) Commission No. _ C (Seal)
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REVIEWS FRON41 i ZONING SUPERVISOR PLANS VEGETATIO SEA TURTLE MANGROVE
COUN :It REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I ,
RECEIVED
DATE • I
COMPLETED I ,
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