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HomeMy WebLinkAboutBuilding Permit Application All APPLICALE,I1 FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Li �,`t Permit Number: 11-1/40 6 0 1417 * . , ;� ''.!..`-'1 : RECEIVED Of ` C } F L CO Ft I nFIE - -= y _.,_.MAY 01 2019 limimmimmommimmir Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce'FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 6/ PERMIT TYPE: PR®PQSE-`D INP"OVEM LUCATIONa ..` d , ° Address: c34 O(10 ft \e-, pi., i-©c-)- p f e rc e Ft ?)L(94-1 Property Tax ID#: IQL10g-{ 1QL-k " 0 0 t`b " 0 CO/ Lot No. Site Plan Name: Block No. Project Name: j Off A°ILE© DESCRIPTION COWORK° bk ss f`n111 S lo C IL1 CONSTRUCTION INFORMATIONo . ,. .8 .oq. Additional work to be performed under this permit-check all that apply: _Mechanical Gas Tank _Gas Piping —Shutters —Windows/Doors _Electric Plumbing _Sprinklers Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of:Construction:$ c530.0 Utilities: .. Sewer Septic • Building Height: OWNER/LESSE .°, .. °a i' ' CO' RAC' OR? . Name i r a S0`V 0 re-s JV__ Name: �hil.,• , Q_E Q Address: iq3 r Co 3 k :�/` 4 npp E Company: (GL S, 74 (-1--'14-1e. City: {'r k,etkA da(� StateF<- Address: /(o(/ (o • 5c.) 7 )-%-/- Zip JZip Code:. � e ( (0 ,, tt-) Fax: City: 1�c�?O l I State: ice(--- Phone No. qS t Zip Code:23 0CQC)` Fax: E-Mail: An,6ifUJSGtpi-IC[f-et,(1,8CO'MCaiSk,Keg- Phone No q jy-len— 1'1 2g Fill in fee simple Title Holdeir on next page(if different E-Mail Co I d, JA7-,I- 6/(1. &964,0,1 L.CDS_C from the Owner listed above) State or County License ‘30Cat 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. NS.'PPI.E igNTa L Co NSTR CIIQN.LI N 04W IN 76RMATi®N° a, • t e ��. s , 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/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:Your fr(ure to Record a Notice of Commencement may result in your paying twice for improvements to your proper y. A Notice of Commencement must be recorded and posted on the jobsite before tt1.e �r-st-inspection.fyou intend to obtain financing, consult with lender or an attorney before commencing worKkr,recofding your Notice of Commencement. r ; ,//f, 1/1 -11(/./ ' )./../, ---.7 Signaturf f3 inti/l!'essse/Contractor as Agent for Owner Signature o Contr.. .r L�-.-.s older f ► -.TATE OF FLORI STATE OF FLORI A COUNTY OFailleb Wotr-cQ COUNTY OF owo, \\\oI l H N l lii#// The forg ing instrument was acknowledged before me The forgoing instrurpent,_wj s acknow,� i dfiSl ' ,� this ay of �1 I , 20`i l th' qday of /q�s', .�. '� �'�I�jiok ccly��, < \\\\ 1 11 1 1/100 i/ �. _- •••. kGwNE 12,?DFfoi..- C� S,©� \ LYN,�R���i/s cJ c��r> �-2 r *' ' �N �0M cs i 4".• Name of perso making stateme c .-'es.12 2a A'•. ' Name of person making statemc�tz:2 F ® = s‘% ,,, _... s �o.; a 9910,0 :* Personally Know Ptrgkliced Idg ification7*E. Personally Known OR Pr sfec2d 'ettifu� fl Type of Identification s ' O •• c Und `.• YP y #FF 991030 Type of Identification !f,G6t'••....1 i\9�` � Produced ��o•'•°%� e ',T 4 Produced c i 'tdc. Dr'ty-ee�i \\\\ -. � ��/,ual/if111l0.0.\ (Signature of Notary Public-State of Florida) (Signature of Notary Public-State o • ida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW - REVIEW REVIEW REVIEW DATE , RECEIVED - DATE COMPLETED ev. 9/26/18