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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST� BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^` 5--0 ��� Date: 5 Ce` ( "I ( Permit Number: C�l'U - � -A- SEC@dI�ED , CG&IITY MAY 061019 F' L COR. 1 D Fi —"s s- Building Permit Application Permitting Department Planning and Development Services '�Uele County Building and Code Regulation Division , • 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSED IMPROVEMENT L1OC'ATI"ONo ° Address: 11O 5 t7ccC z)c `D(e. PLS fL., -c-LQ.R-2 Property Tax ID#: g-Ic P ( cn( ) QCT Lot No.LI (9 Site Plan Name: 5017_D1?_& _5(17 Block No. Project Name: i [MED ED DNCRIPTION Off WORK? ° Ii (-MIL.* J- _--A. - I •Lk _ r-C,- 75._-_cSC 3L pelt) < (t.)& - IL.aJ D Ze9C,1.. ( �i-,- ocx , P f✓- \--_`25- ‘ -itC IC _ .1�,i► ,/ __ .i.� Wit_ _ I•fe.fl' .4OF; �.1i i4l-LVnti.eWZ) CONSTR1tJCTION IN!P"ORIVIATIONo ° I Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors , Electric —Plumbing _Sprinklers _Generator y Roof �( Pitch /.23rD 5)4o Total Sq. Ft of Construction: Z�'jo0 / 41 � ,K-- Sq. Ft. of First Floor: Cost of Construction:$ (Z, (I pp -"1:7 Utilities: Sewer Septic Building Height: C S OWNEROSSEEo CONTRACTOR? ° Name C).A;t. P.AAJClS Name: 5zjs�-' C. }...3(.. . -A Address: L(D5 05c.- --27L.,4- "tie-- Company: I.. a _ ____, ,..,_„:.AL,_ Ute_ 1 City: c 17(. .4-,-2...e.-6- , .State:) Address:3 L OL -i - Zip Code: 3ctc s--2i , Fax: City: Ft- -P e . State: rd_ Phone No. 'n-2, 31-1( ! ---[5—'Z Zip Code: 3 cLi"2. Fax: E-Mail: , . Phone No -7-?-2- 2-1-cv -&-Y4 7 Fill in fee simple Title Holder on next page(if different E-Mail i from the Owner listed above) State or County License C.64.6)5:5-5---Rl (c 2 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. I SUPP'LEMENT6 1 €©NSTRUCTION ME RAM IIMORMATICINg , DESIGNER/ENGINEER: , Not Applicable MORTGAGE COMPANY: Not Applicable Name: 41iAt i� Canoi "i ty Li Name: Address: 9(a `I7k%AJ..c.>yt-1/ /kms Address: City: r gt, 0.--e� State: FL_ City: State: Zip: 3rtei, Phone --z, 21w) /S 1 Zip: Phone: FEE SIMPLE TITLE HOLDER: 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: OUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMP'I ME TO YOUR PROPERTY. A NOTICE OF COMMENC - 'T MUST BE RECORDED AND • POSTED ON E s : ITE :EFORE THE FIRST INSPECTION. IF YOU INTE il TO Oil! • • 1INANCING, CONSULT WITH Y 0 t• END • OR AN ATTORNEY BEFORE RECORDING YOUR N!LE OF CIA),' ENCE ENT." ,,tom Ari, - Signature of Owner/Lessee/Contractor as Agent for Owner Signa ure of Contractor -nse Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF Ll I C _Lk COUNTY OF \---C.U`CAiL-..--% The forgoing instrumen was a knowledged before me The f .rgoing instru{nen was_ acknowledged before me this (J day of 20 (etby this day of �'1f 1 ,---- , 20 (lby $\--v e,� k-,.V,, S // I . i , Name of person making statement. v Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification ,�t- L . Type of Identification Produced I -c 0 Produced J L 'D L E \J f , t'()b .._ (Signature of Nota P_u. .....,-„• '". (Signature - Public-State of Florida) „YP�, ELLEN VAUGHN ```���� Commission No. :o°��.w,State of FI �Notary Public oil, . '� '�>♦.= ommiss on #V GG 270079 Commissi.. , e�. al Expires �I=' �"ti �'_State����N V ;III'o''c My Commission E�xp2.'� _I 110,t Commf Florida No. . REVIEWS �'i ZONING SUPERVISOR PLANS "YVr��w""•r Y® ._b6AA2 " G=ees` •ANGROVE COUNTER REVIEW REVIEW ' REVIEW REVIEW _- __ _ ;'EVIEW DATE _ Wit" RECEIVED DATE COMPLETED ev. 2/7/19