HomeMy WebLinkAboutBuilding Permit Application Ma r. 4. 2019 11 :52AM No. 2081 P. 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: Permit Number:
Lplication
EIVED
Building PermiPlanning and DevelopmentservIces 42019Building and Lode Regulation blvlslan
1300 Virginia Avenue,Forr plerce Fk 34982Phone:(772)462-1553 fax:(772)462-1578 CommercialqQ
PERMiTTYPE: Unher9rc," ele-kr c, -
MOP 151101MPROV fUiirNT LOCATION:;:•' "`
Address: 86x3 019" sine rlve_ Fore- ejrrct: FL.. 3WI`i`f
Property Tax ID 4; a3a� 'roCSO -GCJ%!A OtM Lot No,
Site Plan Name: Block No.
Project Name:Cree11;iJet _ Wesk F., A{-.ern
DETAILED;i7ESCR(*'' N•OF gORK::: 1
6 wrla r_ 'c^+ wir wh7a ' d 101 4m4n C.. ..a .
_+rcnc:ker 6e twee,% FPL- llac44 kotc and o.+.� ,ice' uv�o Fe r cy•+
:;COATS UGTION,INFORMATON•s:
Additional work to be performed under this permit-gheck all that apply:
`Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors
.fElectrlc _Plumbing —Sprinklers —Generator _Roof Pitch
Total sq.Ft of Construction: _ Sq.Ft.of First Floor:
Cost of Construction:$ 111' Utilities: _sewer Septic Building Height,
OWNERAESSEE: CONTRA 7Ofi'.
NameD P, i(orle., ,�, Name: ' ttr;s�inat AA S Ia+t
Address 430 lydtvtr II YC Company: 9e,,j
City: — w state: FL Address: 1 016Ywd..r i i IR
Zip Code: Fax: 9666 843- 48 It City:We'd- 5tate:_Ef.
Phone No.�e91^ ^-7111.1 Tip Code: 3 A 9 6 L4_ Fax:
EMail:S(� re.}`►1 Q{� ,r}a� fowl Phone No 3a� -1618-
Fill
1618-Fill In fee simple Title Holder on next page(if different E-Mail Ch,;, '!AA t- aV('Wg_iJr. .a
from the Owner listed above) State or County Llcense I t?14 55$
If value of cansVuctfon is$2500 or more,s RECORDED Notice of Commencement Is required.
If Value of HVA{Is$7,500 or more,n RECORDED Notice of commencement is required.,
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Mar. 4. 2019 11 :53AM No. 2081 P. 2
S,U.PRLE�Vt�Nl'AL.ICQNSTRU�TION LIEN LAW.INFORNfATION
DESIGNER/ENGINEER; Not Applicable MORTGAGE COMPANY! _Not Applicable
Name. Name'
Address, Address:
City: State: City. State,
Zip; Phone Zip Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable .BONDING COMPANY: _Not Applicable
Name' Name'
Address: Address:
city: City:
Zip: Phone: Zip:-Phone:--
OWNER/
ip: Phone:OWNER/CONTRACTOR AFFIDVIT:Application Is hereby made to obtain a permit to do the work and Installation as indicated.
I certifythat no work or Installation has commenced prior to the issuance of a permit.
St.LVcfe County makes no rep►esentatlon that Is granting a permit will authorize the ermit holder to build the subject structure
which Is In conflict with any applicable Home owners Association rules,bylaws or a�$covenants that may restrict or prohibit such
structure,Please consult with your Home Owners Association and review your doe ar any restrictions which may apply.
In consideration of the granting of this requested permit,l 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 addltlom,
accessory structures,swlmming pools,fences,walls,signs,screen rooms and accessory usesto another non-residential use
"WARNING TO OWNER__YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT AJAY RE5ULT IN YOUR PAYING
MCC FOR IMPROVEMENTS TO YOUR PROPERTY,A NOTICE OF COMMENCEMENT MUST HE RECORDED AND
POSTED ON THE JOIE SITE 19MRV THE FIRST INSPECTION.fF YOU N ,END TO OBTAIN FINANCING,CONSULT
t'trfTH YOUR LENDER OR AN A7TORNE.Y BEFORE RECORDING,YOUR F40TICE OF COMMENCEMENT."
SEgnaturegf0 Lessee/Con tractor as Agent for Owner 5 atureofCo- rector/LlcenseHolder
STATE OF FLORIDA STATE OF FLORID
COUNTY of r r COUNTY OF
The forgoing Instrumen a acknowledged before me The for Ing Instrument was acknowled a before me
this '�dayof 20[' by thls,��,dayof I%P_h 20�.by
r �� Yfksk 1Y1E1t AnR
Name of person mo Ging statement, Name of person making statement,
Personally Known Produced Identillcatlon,_„ Personally Known OR Produced Identlfleaklon
Type of Idendffcatlon Typo of IdentlFlcatlon
Produced Produce
(Signature of N tary P C-State of Florida) (Signature of Notary Public-State of Florida
Commission No, & !`t�a 501) Commission No.
_WL222ZI0q (seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW'
DATE
RECEIVED
DATE
COMPLETED
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