HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p /,,
Date: b-8 Permit Number: L LC 6�/
RECE1VEtS
-:: MAY 2 0 2019
COUNTY
F L 0 R 1 D: A - Permitting Ognartrnpnt
inimmisionsmomi Building Permit Application st.Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential .x
PERMIT TYPE: ck G l
PROPOSED IMPROVEMENT LOCATION A „ ..
Address: \ \ -5 (o I') �3\e5 L)k o[X
Property Tax ID#: L-\ 50 -a, - 5 o t- 3 a3000 - CS Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF,WORK
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CONSTRUCTIONINFORMATION:
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:$ 11 oL 50 . O 0 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name �c0 rbe t-Acu-c 9-10.03. ck Name: R o\c, 0RitvOL )I AK
Address: Map,(v 1J 'O 9ccee Company: 'mac\i e r 10k11�v\
City; ‘; Cu.1n State:FL Address: I a 31 (OE ‘m v,t"‘Se,
T-esrftt r_P
Zip Code: 3 3D 1.14 ' Fax: City:-372,1/1 Sev\ Rre_aC.Stit L State:?L
Phone No. 305- 5 01 - (D(p 55 Zip Code: 3 et 41 Fax:
E-Mail: jhrAkJ;ct 5\ e yvaG,-,1 o Go w% Phone No -Z1 a-' "Ion-l- O 1 'I
Fill in fee simple Title Holder on next page(if different E-Mail \o\pt'c"��,1P.C�C1 l l�v�t�e c. �i L Czcv
from the Owner listed above) State or County License L C. 130((05 1 '
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
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION li
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address: I
City:
City: I
Zip: Phone: Zip: Phone:
e work and installation as indicated.
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the
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.
agree consideration of the granting of this requested permit,I do hereby g ree that I will,in all respects,perform the work
and St.Lucie CountyAmendments.
withthe roved laps the Florida BuildingCodes
In accordance pp p
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 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."
tV� Cr
Si naContractor as Agent for Owner Signature of Contractor/Li ense Holder
g ture of Owner/Les ee/
STATE OF FLORID STATE OF FLORI
COUNTY OF c,k -0...._ COUNTY OF 4c c,.e_
Thergoing instrument was acknowledged before me Thg�f rgoing instrument was acknowledged before me ,
this cd day of (`c A ,20V A by thi day of 'x1 v ,20n by
CZti.--1/4 -evt-NO k.A. c..—NC___ r--\... .93\c:-.1e.c-k --&=K-1-0%.1.3 4=t%.1C.-
Name of person making statement. Name of person making statement.
Personally Known ✓ OR Produced Identification Personally Known ✓OR Produced Identification
Type of Identification Type of Identification
Produced z� 'di • STELLAM HUNTER I
Produced
?°/•� � Notary Public-State of Florida (
XP Commission#GG 281062 o1►R '' ST LLA M HUNTER
_Skgtk\ � T,....�. ` My Cornm.Expires Jan 23,2023 Ic56 :?� :•• ary Public-State of Florida
U• W B ^'gyp uu'i^^il"'vary Pccti ( E kaon M CrG 281062
(Signature of Notary P (Signature of Nota P . I St�Oecaf�FIGIjtlds an 23,2023 I
Bonded through National Notary Assn.
Commission No. (Seal) Commission No. —(SeaT) — —
1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley.2/7/19