HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: �- 1� �� Permit Number: if , 033A
- RECEIVED
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Building Permit Application
JUN 17 2019
Planning and Development Services Permitting Depa tmen
Building and Code Regulation Division St. Lucie C nty, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: ,[ (�r2erl /ve Jrn4i'I LIC mj zl- 1 Oft•
�xd �74Ya> 14 � T � }s{ice s � h a ass rxaz a
PROPOSED INPR®V¢EME1ti1TLOCATICIN �
e ,n re • rte fu-ire* 4 r taa Q� usti _ s m _ _t'-� '_ c as s'
Address: LA U(2 isP �CLm/}N OAs- ccb les4-tioe a►yt r� Meta 3ggyr
Legal Description: C1ZeC14Sl Ov P1Ct4 NO, ) C PFJ 5' 12� Lo-f 30
Property Tax ID#: 023 0� (P " (P C)I) - CO 3S ' 000 - j Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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CQNSTRl1CTi41U MIT; ONF.� .9� �z.. .. . . . : �
Additional work to be performed under t is permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: a
Cost of Construction:$ Q00 ; °~ Utilities: —Sewer Septic Building Height:'
®�V1/NEE/LE-�SS' E �i00
0 x CONTRAaR
Name Lauren 'NeWaw) Name: .:•1- OA- ',
Address�S Cololo�Q S- �ry Company: L1 ) Scc�en� nc LLC_
City: 'Pl`2`f State:(-:"(. Address;22qM'
Zip Code:-3,` Qi'�{J�-.. ,fFax: City: _-....plZfZ:e - State: (F(
Phone No. , ..>.re,_.r_........: . . .,. Zip Code: 3L/4 J r Fax:
E-Mail: Phone No to-) 3
Fill in fee simple Title Holder on next page(if different E-Mail��. S 2.�q`"1 �rna`,�. Cans
from the Owner listed above) State or County License 3 00 G 3
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
1
� 1N .lENAOQS WAw
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: c 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. LucieCounty 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
structures 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice-of Commencement.
Signature,of Owner/Lessee/C ractor a Agent for Owner Signature of Contracto nse Holder
STATE OF FLORIDA.,, STATE OF FLORI
COUNTY OF COUNTY OF
The forgoing instr t was acknowledgVb
fore me The for oing inst e was a knowledged before me
this day of 20y this �� day o 20�&by
Al 41Na, an
(Name of person acknowledgin ) (Name of person ackno edgi )
AUA,
(Signature of No Pu tc-State of Florida
a (Signature of Not ry ublic-State of Florida) /
Personally�IF n OR Produced Identification / Personally Known OR Produced Identification
Type of Identific i n ,J �} Type of Ide tifica '
Produced (/D�' .JU L Produced '
'rv'u AUDREY B.HU�P^H,�REIf
Commission t Commission NIP
*' *' *• :;: MY COMMISSION#GG 300817
:o EXPIRES:March 6,2023
v., :A: r-XPIRr=SmMatch2 23
TOFF°• Bo Thru Notary Public Un&
REVIEWS FRONT ZONING SUPERVISOR PLANS VE GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW 'REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014