HomeMy WebLinkAboutBuilding Permit Mar 27 2019 10:01 AM HP Fax Page 2
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0�l
Date: Permit Numb r:
r
RECMED
Building Permit Applic tion
Planning and Developmerit5ervices
MAR 2 7 2019
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St, Lucie County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial R sidential
PERMITTYPE:
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Address: Gtr V 41^ M J G
Property Tax ID#i: O� — 0 0 0 — Lot No.
Site Plan Name: Block No.
Project Name:
ary 3oao � w e �o a a+T
Ge
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Additional work to be performed under this permit—check all that apply:
4Mechanicai _Gas Tank _Gas Piping —Shutters _Windows/Doors
Electric _Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
CL-
Cost
Cost of Construction:$ 49 3 Od Utilities: —Sewer _Septic Building Height.
Df 06 IfSf! V AW e iS
Address: 4 �) 1CA6r N S Company: R. Y Ca^ f a
City: W" b C'� [&'-J tJ#r State:F[ Address: 5— S i u sr oa,I- r
Zip Code: 3 3 JI 14 Fax: Al R City: do Q)br State: ,=
Phone No. �%2— ��8 ' !t/S Zip Code: 3� Fax: i9� —540-G6/3
E-Mail: Aj4 Phone No G. 66
Fill in fee simple Title Holder on next page(if different E-Mail � r e G • o
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is require .
If value of HVAC Is$7,500 or more,a RECORDED Notice of Commencement is required.
Mar 27 2019 10:02AM HP Fax page 3
DESIGNER/ENGINEER: Not Applicable MORTGAGE COM PAI` Y: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip• Phone Zip: Pho e:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY, Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Pho e:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to d D 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 coverants 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 Arneiidments,
The following building permit applications are exemptfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls, signs,screen rooms and accessory uses o another non-residential use
"WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEM NT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMEN EMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEN TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE COMMENCEMENT."
j�Z o%4
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/ cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY Of ,T+,Lyt.iQ, COUNTY OF Luc,e_
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l-I day of 1di0a 6 120A by this2-t day of rI v, 201 1_ by
4,o6crk L, 66eyk C. enrA%s
Name of person making;statement. Name of person making tatement.
Personally Known OR Produced Identification Personally Known X OR Produced Identlficatlon
Type of Identific Type of Identification
Produced A M
R�AIRIBYIA$ARM Produce
IiI1/CO M MMONOG$21 10t ON
FtOWo�lr2a,ip� '' R002TOg0eZ
(Signature of Notary Pu fic-State of orida) (Signature o
Commission No.F1590 (Seal) Commission No. t� 5 0 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIC N SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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