HomeMy WebLinkAboutBuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: Permit Number:
F �. RECEIVED ter`_
t
Building Permit Application Nov:o5 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: I V 1 Z- S' iV r 4 l
Property Tax ID#: u 57b2- &S- [�j3s= O���� Lot No.
Site Plan Name: Kgner95 Block No.
Project Name: -i��'7�S
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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:$ 6w,61) Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Tovp, Name: Jjft� _�.�,OjcX ►c")
Address: l o)57t S 772 T Company: _5egNKEn. 3!�y pluAy'y M
Address: 010 Iljw (�
City: ���� State: ��L.y�,gL
Zip Code: 3Kct,;2 Fax: City: fin/— State:-fl—
Phone No. Zip Code: V1 ffy Fax:(�
E-Mail: \ S to r yza55ea C-OL', Phone No V• awo
Fill in fee simple Title Holder on next page(if different E-Mail 6o3neovIA. 60
from the Owner listed above) State or County License ('(3
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 LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 66IMr J e Name:
Address: (&2C" (,z;,rW touw r Address:
City: krf2ZR 'gejrA{-, Jq— State: City: State:
Zip: :jZQ(,-7 Phone �1•�'Z'? � ��J 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.
K 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 view:room Aitions,
accessory structures,swimming pools,fences,walls,si s,screen rooms and accessory, s to anothe non-residential use
"WARNING TO OWNER: YOUR FAILU O RD A NOTICE OF COM MENT M ESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS UR PERTY. A NOTICE OF O CEM MUST BE RECORDED AND
POSTED ON-,THE J S E T IRST INSPECTION. IF U T BTAIN FINANCING, CONSULT
WITH YOUR L NDW ORIAR14 r EFORE RECORDING YO NCEMENV
Signature of O er Less /Co ' r or as Agent for Owne Signatu a of Contra icense Holder
STATE OF FLORIDA,,-a ' ' . p- �, STATE OF FLORIDA
COUNTY OF Uk-�-�s1, COUNTY OF - Q
The forgoing instrument was acknowied a before me The forgoing instrument was acknowledged before me
this S_day of N Cie 20��by this S day of NC�,I R .. 201R by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known t/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
1.i�C,C�c.)`
(Signature of Nota ublic-State of Florida) (Signature of Notary P c-State of Florida)
1Ay Po
....V RANCES V.JOANS °�µ'•P."��p FRANCES V JOANS
Commission No. 3 *( g Commission No. * 15M�OMMISSION;IGG03 8
MMI:OdD 8 GG 030038 °� `tee EXPIRES:000ber 29,20
`"yr `ate EXPIRES:October29,2020 h. °F
8� obry 5c , s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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