HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.Date: 05-2,p-20(9 Permit Number: \4\05-0 5a Z5
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RECEIVED
9
1 Building Permit Application MAY 21 2019 I
Planning and Development Services i
Building and Code Regulation Division t tlwia Pm t mittiha f
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential �-
PERMITTYPE:
PROPOSED,INlPRQVEMENT LOCATION:„
Address: 59D q
PropertyTaxlD#: I20(-`l' –Oo$8– 00D/1), Lot No. 1
Site Plan Name: ,J1Block No. NO
Project Name: AIA
DETAILED DESCRIPTION OF WORK 11rL tryi�F �,leo� ��„z� x;,r, t
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CONSTRUCTION,INFORMATION i
T S r. i
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 120 144, Sq. Ft. of First Floor:
Cost of Construction:$ 2 IOD Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE = .. CONTRACTOR k
Name V ski' �b-A Name:
Address: 53W Qh&ce G e.- iJ Company: S cr LLC_
City: ro,+ Aerct, State: Address: x(853 (-Is+ (arc.,
Zip Code: 34g5( Fax: City: oes-', State: FL
Phone No. Zip Code: 3Z4��7 Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License CGG J 52(p3�
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.
SUPPLEMENTAL CONSTRUCTION Ll EW LAW INFORMATION
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: Stater
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 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 ANA ORNEY BEFORE RECORDING YOUR NOTICE M -pleEMENT."
S' ature of Ow ee/Contractor as Agent for Owner Si ture of Con ctor/License Holder
STATE OF FL STATE OF -O�R,IIDDL
COUNTY OF �� t Vt COUNTY Cf ! A-21
The f?gping instrument s acknowledged before me The folding instrumen was acknowledged before me
this day of 20��by this day of 20C by f r
1 ✓l17
G \ ✓1 L� J �J
Name of person making statement. Name o person making statement. /
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of entificaY n r^ Type of I ratification-
ProdProduced
a� Brian To 0 o��ar n&e4 Han To
I State of Florida
state of F104"n -
(Sign . a n i H
(Wires 03/13/2022 (Signature of No u R3p"pR Pres 03713/2022
nlmission No. G 195361 �J Ffv° _Commission No.GG 195361
Commission No. \ (Sea] Commission No. C�� �GI9 3�r� (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19