HomeMy WebLinkAboutBuildling Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C/ (
Date: 5- ( 4r C3 Permit Number: I 1 0 51i1
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COU NT Y RECEIVED
Building Permit Application MAY 14 2019
Panning and Development Services
Biuilding and Code Regulation Division Permitting DepartmentntY
5, I e Cou
2300 Virginia Avenue,Fort Pierce FL Jam"
Phone:(772)462-1553 Fax:(772))462 462-157$ Commercial Residential
PERMIT TYPE: m g
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Address: S'(.\o 34n(f1 c Lane.
Property Tax!D#:73,1 I b S d 3 -O-7O����" l Lot No. 38-
Site Plan Name: Block No. fi
Project Name:
y'`¢ �' #7 a A 6 d Rin is ry .. a S �'W 1 t �M 5 t��
14*-510,1
P\-e.--co rjle, j\r"
';',„4/46a i ddr d 3 'E �$ Ar , fRr; 4
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors
Electric _Plumbing —Sprinklers _Generator 1. Roof 5 Pitch
Total Sq. Ft of Construction: 'dk-,,o0 Sq. Ft.of First Floor:
Cost of Construction:$ f 015 o b Utilities: _Sewer _Septic Building Height:
/��� s u . s e n :✓ -7� ap/
. &. .' th)o w ;4-9,41;1#
Name Will it;Mk
Name:cZ, tke
Address:SD( S Cn"S Z-A, 1- Com pany:J�1t><e-k,,'1'�- :> ie-
City: ei- State:Et-- Address:t`(13 I
Zip Code:,7 '( `► e�- Fax: City: P 0 C k' Sc *t State:cC.,
Phone No. Zip Code: 31-( g Fax:
E-Mail: Phone No'11 Xb ) I S S
Fill in fee simple Title Holder on next page(if different E-Mail S ko r t..\;ne Cc)0c'A S s(nuO, weri
from the Owner listed above) State or County LicenseC-C-C_(33 lL l 1
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.
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DESIGNER/ENGINEER: _Not Applicable ' MORTGAGE COMPANY: Not Applicable i
i —
1 Name: Name:
Address: Address:
l City: State: City: State:
Zip: Phone Zip: Phone:
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3
I 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
1 "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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
ges_ �'V IF 1
Signa Owner/Lessee/Co tr ctor as Agent for Owner Signature of Contractor/Lice `0 older I
STATE OF FLORI[4-‘^_ STATE OF FLOt�!,qA
COUNTY OF ° 6P-kt3 COUNTY OF �f )QT1U !
The,fgr oing instrum was acknowledg before me Thgf, r oing instrum t was acknowledg oefore me 1i
this`'!-i'fday of ,2011 by this`1 Y day of ,20l' by
NA ancl WI (tel and lc
Name of person making st to t. Name of person making statement.
Personally Known OR Produced Identification Personally Known V OR Produced Identification ' f;
Type of Identification Type of Identification
Produced Produced
TTCLMA Mao 'aca.fl Gl-)W\_S-
(Signature of No Public-State of Florida)v Pu BRANDY Mature of Notagrhublic-State of Florida) -
G� �02�3g t►� B 1lgY PUBIi BRANDY M SORE
Commission No. 4- ,,,, * Commisslon#GC,102839 GG i 0
C ssion No. 1 V GG J ( * v I;1 * Commission ItG3102839
N,,, :e Rt' °a< Expires Nay e.
Nj�'ii'• •oma Expires M.y9,2021
7jFpp;VP' Banded Thru Bud fat Notary Sorvtcoa ,/�F061F�0¢� Banded Thru Bucket n nary Service,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE! 1
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE '
RECEIVED
DATE I
COMPLETEDi
rev.2/7/19 - ___