HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: I �G,. I Permit Number:
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.__R._ Building Permit Applicati n
111111111110 DEC 16 2019
Planning and Development Services Permitting D e p a rt m n t
Building and Code Regulation Division St. Lucie Count
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT TYPE: � � e
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!-'PROPOSED l,MPROVEI111ENT LOCATlQN
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Address: -- (ZIN VZWO LOC-f�//1D� '!"2ACi_ - Q011-r 5A1AJ7 LUGiE. cl- 3�F�
Property Tax ID#: 0 Q Q Lot No
Site Plan Name: _ _ Block No.
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Project Name:
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"CONSTRUCTlON 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 2 Pitch
Total Sq. Ft of Construction: 5� 0 Sq.Ft.of First Floor: /
Cost of Construction:$ 365-00 Utilities: —Sewer _Septic Building Height:
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�OYV NER �ES�EE d 'f" Ra'�1ty4 3 ,S.ay t ria�tk rti-t rn iEd c t i��r�t �
CONTRACTOR
Name A166t P6AeP- (fOUNTA Int PLA-.,A Nq) Name:_ i6U(LLE PI 0 5A•WA'/
Address: 121'7LJ f-11169heAJD -r11A E Company: C-Ily Ro0hiN6 I/UC
City: Poevr SAINT lve1e State: FL Address: 3114 r'E U,1,0UQA le ST.
Zip Code: 3 Lit?9 Ll Fax: City: Slut4aT State: P L
Phone No. Zip Code: Fax:
E-Mail: Phone No '7172-285,9�33
Fill in fee simple Title Holder on next page(if different E-Mail (9S ra tJ C1)yl I-ov���I�Sr'e+/iee• �o n�
from the Owner listed above) State or County License
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.
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�SCIPPLEMENTALCON�tRUCTION LIEN lA1N�INFQRMATIQN ' ;� . y� �'� '� � x� s�� p � ,N �
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 YnU 11qEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y R TW OF COMMENCEMENT."
Sig ature of Owner/Lessee/Contractor as Agent for Owner Signatu f ont ar License Holder
STATE OF FLORIDA �_ G STATE OF FLORA A
COUNTY OF COUNTY OF MAiGr1AI
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this L_day of SA rJ20_.Lj by this 11 day of P6-6e-4,1,301— ,20JJ by
LoeL A2-e,z
Name of person making statement. Name of person making statement.
Personally Known_ OR Produced Identification Personally Known Y OR Produced Identification
Type of Identification Type of Identification
Produ' d Produced
O S M E L VA L D E S Notary Public Stats or Florida
TU N r Maria Y Cajacha ua
(Signature of No 3tl�t WW@Wdaft)GG 356648 -(Signatur otary Publ = FIE�gi 75i&23
.; of�oP°� My Commission Expires
VA July , 023 6&a (Seal)
Commission No. Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.