HomeMy WebLinkAboutBuilding Permit Application Y
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J_o�.7_,('� ��I
Date: ��9' `il Permit Number: (�lQy
Building Permit Application
RECEIVED
Planning and Development Services
Building and Code Regulation Division AUG 2 S Zoo
23QO Virginia Avenue,Fort Pierce FL 34982 ng Department
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ude County
PERMIT TYPE:Roofing --�I A-�
PRQPOSED IMPROVEMENT
Address: 5813 DeLeon Ave. Fort Pierce, FL 34951
Property Tax ID#.. 1301-613-0228-000-3 Lot No.13
Site Plan Name: amu_ Block No. 14Y7
Project Name: Michael J Curl
DETAILED DESCRIPTION OF WORK � s '° `
Tear o{-P kis+;A f oo-� 'I ns (�l I 3 I v S Sit n-,
COST ; NO
41
4N MNv,
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _ShuttersWindows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof - 0112- Pitch
Total Sq. Ft of Construction: Too Sq. Ft. of First Floor:
Cost of Construction:$ y Dao• O a Utilities: _Sewer _Septic Building Height: ( (�
DOWNER/LESSEE 3 tF a CO(UTRAGT�R waa
Name t') IC''kag I Name: It,an Mltilr*iYl.t2-
Address: `rj 8� 13 Dr V--f-un (-S ✓e Company: t 'Koofi r1 S +fr"�=r
City: nv Pi-e r Ce- State:_El:. Address: _32- G I S 1= p �t rr
M �n� cam.
Zip Code: 3 y a S I Fax: 1-I 2--£t-12-- 033 City: S-ty'VH- State:-E-L-
Phone No. "1 -7 Z- 8"-72--6-0-70 Zip Code: 34f77 Fax: -1-72.- C72 -"Z
E-Mail: 5 m-i rA- ; e. Phone No 1"12- 12 -�r03 0
Fill in fee simple Title Holder on page(if different E-Mail r++; rIfGlrp
from the Owner listed above) State or County License c
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.
5;[JPPL EMENTAL CONST°FtIJCTI'ONL`IEN aIAW INFORII%IATION'
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 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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND T0_0BTA1N FINANCING, CONSULT
WITH YOUR LMR OR ANA ORNE BEFO ECORDING YOUR NOTICE O MMENCEMENT."
Sign re of Owner/Lessee ontr or as nt for Owner Signatur f Contractor/License Hol
ATE OF FLORID TE OF FLORIDA 7 N
NTY OF M'l a r4',h COUNTY OF ,c e-ri ul
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d f orgoing instrument was acknowledged before me The forgoing instrument was acknowledged before m 0 N
Z 11- 2�S}day of �� �S -E 20J by this of 201L by o Q
0
�
QSIL of person making st menti. Name of person makiA�stat ent. z
Wally Known OR Produced Identification Personally Known Produced Identificati :'m�``'ep%d'=.
Typ of Identification Type of Identification
ced Produced
_a
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. G-rGr 11 13l (Seal) Commission No. CSI 913 1 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
. 2/7/19