HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date:,�` Permit Number:
RE
s� :
RECEIVED
Building Permit Applicati n SEP 17 2M
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: AC 0114U(r- �Pv'r
Address: 6016 CA 5S:UA 151- T!3:VI?-CV 3,ggV7
Pro pertyTax ID#: Get) -ay1N 'csd0^� Lot No.
Site Plan Name: Block No.
Project Name:
t 1 E+ D' ,CRIPTIO U •R :
ck\Away OL-17- Or�_ Z. 5.+&" a-c V rN:t'f w:FT if 71Cw 11,01
r 1Y sb�0-
C�t+3 SRC (� (Nf=Oft+ C•�N�
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, :Pit:ch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ moo Utilities: —Sewer —Septic Building Height:
M, R 03 G•NTRA
Name '7€I1N1::Fe L l4-%,SL.S Name: C-,ysrAWO
Address: %30 'E WTLL:Fkr%5 5-l-` Company: C 5-rd A:x V—
City: SCE ''' ,' - =_ State:Oft- Address: 7$72 4 Sw SW ES7F ff r6 GD ST
Zip Code: Fax: r City:: ®Q'r :L`�G = State: �G
Phone'No. 77- -t -88Z."J51367'' .,Zip;Code: 5;3' 'Faz:
R
E-Mail: Phone No �11
7Z $5.31 r.
Fill in fee simple Title Holder on next page(if different E-Mail Qvslr l4-t EL&k�'E-GO ASL_ COrA
from the Owner listed above) State or County License CArG 1$I iO4"l
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.
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 obtairi a 'Permit pto do th'e 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 YOU 'ENDER OR'AN ATTORNEY'BEFORE RECORDING'YOUR'NOTICE-OF COMMENCEMENT:"
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF 'Skr. COUNTY OF N- c%&
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisN'O,\ _day of 'S2 201k by this \1 day of $! Q} ,20_1!� by
,��v�-�►-�. as To t l� S G�sac�Jd "=o tt QRS
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 * L, L- Produced
(Signature of Notary Public-State-of Florida)• (Signature of Nota ublic--State of Florida-
S
Commission G1VX15B Commission N , , aB�� 023...
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REVIEWS FRO OR PLANS VE T`7X�, MANGROVE
COU E '.N��� REVIEW REVIEW R REVIEW REVIEW
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