HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a U
Date:�YJ t .7.��� Permit Number 1 i
RE:EIVED
x i 4
Building Permit Applic[ti.0nEB ` `.Planning and Development Services ucie County, Permitting '
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ResidentiaP
PERMIT TYPE: ���
PRQ,'P PRQVEMEN L rA `jp � a f txs, r
r 1., .> .,n .. .-s.1 � �r. .. ..:• -„ ., A N`,. E�,'Y .,��� ;*x.'F`,.w. <,d' ..rs,.�F, � .r N.S,er '+ .,4�.. •s;'..r, ..�+;x
Address:
Property Tax ID#: 3�3 ' S_�Z' 9 Lot No.SC�3
Project Name:
EI� F ���}������)�\ Thla� a�waS`•. , i�. qt�0 A�^S $ � '�b�k A�>`�rxf ap'�` L 5 E� � F yrs t 1 � �.3. 5
�w�r. ���a ,a r„ .`�`Eta�„�k.�i>f� � -,� r ,Gx, w rv'n.� #e: �'� �,"�„ •..y �,�_. ,?R ,� � ,,� t.,zs� s.. dr ,a�,A
Wl a'
ANTI` wv"r �rx, rvs� ra j yr r�
CaNaTRU x iaNINFaRf�N`
5�
Utilities: _Sewer _Septic Sq.Ft.of First Floor:
Cost of Construction:$ � L�� ' Total Sq. Ft of Construction:
P- R,S. #
a'" .r h'br. a, >*�"�
§ �:Q;PLA�1'N fl zE . >P111�EN. RERM`ITR� dfistructxafes !Xempj r m�B0 dlni Code ttrava`relin they
�4 g,4,r'fcS:L °}�z �; 'c.{�',vn'3w
MEN
.9s ✓ 'E> 2 a'x + �,,rT f , a
1✓tN r;+,4,�'E 4 3'�tb vig ,y> � •d3:-r; k�1 y i ,} C �' S k”' b a_. F
��IOCI Ii,, .a Sj rfl
' t'�; <;,:„
{'+ �::^+�'€"'u a ;",4',,era. x ` ai' �msy l� �"`}�3 to c� w -d�'y '"C,n,'p:
Nonres r n#{dal rm u1 din �yedus d excfusivei(��far�canstiuct 6m;: � �
,� SI 7"" vY S-
yMotsile/Ms i ar foritemp constni �on offices. Bldg i' olv d iii d trib of+ t c i ci r �
l i ti -'° t�-��`i �'l
sathe�;� BfiEK� ='.K �,Fio�dvaj1 Y N I Y
N 'Rise Ce I sat .w thy�o��rporirig taatach d?Y/N
�
Ail vti�er a,pp Icab�e state�and�feder�l ermits�s "all�be;�o� a d prior�t°s, rnmencemnt of��� ��,¢��;
t. ,+ xr.^4 da1,R a}, 4 "d€ a i Z § ,rr r;tfi
wrulwR �i: sEr_ e � g� 5 car�rAiraRr � � r ��t F
"" urR. i '�k.brS �, j s ` �
Name{[✓ �C��� C3 Name:_
Add :5 7C� Te_r12cj,- A_>_ ' Company:
Gt�AC7/-�- ��rC� State:( Addre �q2e� S—�
Zip Code: Fax: City: uk_tc W State:,
Phone NO.T1? . oJ, �� Zip Code: Fax:
E-Mail: Phone No
Fill in'fee.simple Title Holder on next page(if different E-Mail C.� c- � lC)1 uL ry-ai
from the Owner listed above) Stat my Li nse 3� i -
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.
Al" ASr sitx't ;ttram, ^, `,� Y i
UPRL n t�T� L G CTION L EN LAIN I
NSTR� IF,OI MATIC
"'y":.Laam r '+s...a."j8ta..•).Y�_^R'r: a N'�-Pv�at,'�.W,€,'., -Hx - ,,,, 6 .-i �:."-ifs. .<?.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE MPANY: _Not Applicable
Name: Name:
Address: jAddrels:
City: State: State:
Zip: Phonep: Phone:
FEESIMPLE TITLE HOLDER: _Not Applic a BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTO FFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 theapproved 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
comrr1en
-Ing-worker-recordin our Notice of Commencement._ - ----
Signature•of-Cwner Lessee/Co tractor as Agent for Owner Signature o Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF -S . \,-yc Ot COUNTY OF_ -,A, VA C t�
The for Arig instrument was acknowledged before me The forgoing instrument was acknowledged before me
this r�day of '�r 112. ,20J by this�dayof 'cam 2019 by
C3 U-� >^ n q w-�.O S S !>CN V` V,a1'A S'S
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced t, Q
of Nota ublic-State of Florida. (Signature of t S eQwp
(Signature ry ) � g Via" .' �
F Fig.;,:..:,.•.
Commission No. �d ARt�GN�RSNo1afY '"'
pM 23 ommission No. -a I
dip':°u°:�'•; M.�COMHdSS101� G Gpy2U620���c `�Ea:.`.�•'
REVIEWS FROM ",;�rE.. led OR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT REVIEW REVIEW REVIEW REVIEW REVIEW
20
DATE
RECEIVED
DATE
COMPLETED
ev.1/9/2019