HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: AZA • 99 . 1 9 Permit Number: f q/ 7.—0 ' (0 I
RECEIVED
DEC 0.9 1019
' Permitting Department
- - Building Permit ApplicationSt. Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _
PERMITTYPE: Tern pvrArV mower Pole_
PROPOSED IMPROVEMENT LOCATION:
Address: M q 7 S pend)-hr-'-fA Z4 ne
Property Tax ID#: 33 a -5aa - DD y LJ- DOD 5 Lot No. I S
ESQ bR) C'.ree
Site Plan Name: TCi r 7 d� ) i RPS j'leI C pN
Ce Bloczk No.
Project Name: 7-0, rrne, n,` a i Resi e nC-e
DETAILED.DESCRIPTION OF WORK:
:T"r)s'-J I (fin)-rel rWrn S ex�,�o i-CL r-� iO0 )e_ 7LD b
re vete( G,f 10
7909- 0031
FONSTRUCTION•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:
Ob
Cost of Construction:$ D tg Utilities: —Sewer —Septic Building Height:
I
OWNER/LESSEE: CONTRACTOR:
Name )< roL _r0 rrnarni rn , Name: SDS h C . �V-nd on , �Address: �r-1 a►a ���1e chC,-S.0 CDtAd Company: SOe.s 1F:,k C,iY i G
City: DOD JAA CA e- State: F1- Address: 120b Be,)1 I?Ve y)uj�
Zip Code: 3.4018 LP —'; Fax: City:
V-6L+ f)� el GR, State: �P L.
Phone No. Zip Code: 3 Q1$ Fax:-
E-Mail: Phone No 77a '14P`,512 3 (03
Fill in fee simple Title Holder on next page(if different E-Mail J u"e ),L ori-,
from the Owner listed above) State or County License EC 43 0072 D3
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.
I
SUPPLEMENTAL CONSTRUCTION,LIEN--LAW IIN`FORMATION: `
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: )CNot Applicable
Name: Name:
Address: Address:
City: State: City: State:'
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X 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
WUM-YQUR LENDER OR AN ATTORNEY BEFORE RECORDI UR TICE OF COMMENCEMENT."
SS?
o,� G
Signat e o Owner Les ee/Contractor as Agent for Owner Signatur of C ntractor/License Holder
ST E OF FLORIDA ST OF FLORIDA
LINTY OF 5T Z aeie C NTY OF ;5�% 4ece-e
The fording instrument was qcknowledged before me The forgoing instr ent was acknowledged before me
this 9 day of 20/Q by this day of 20�by
_-qlp_,o A 0!6 Ale IN W(g"i �r
Name of person making statement. Name of persorf making statement.
Personally Known_�ZOR Produced Identification Personally Known_t,-' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature ofNotary Public-State of Floril1dcca��'')II,, (Signature of Notary Public-State of Florida)
Commission No. Notary PUALP@Dle of Florida Commission 0. r otary Public State of F&
Randolph McDaniel Randolph McDaniel
C. My Commission GG 352355 � • M Commission GG 352355
a R s for tU xpir S09/07/2023 i
REVIEWS F R PLANS NGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
2/7/19I