HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE•COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:42-It-d Permit Number: V:k 1a-46313
RECEIVED
® DEC 13 2_,x;9
s
Building Permit Application '
Planning and Development Services ST. L Cie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE: q c baa
PROPOSED.IMPROVEMENT LOCATION:
Address: V olio iUGt> Lcs.t, relck(A k z_Nr of� ", YQg 0
Property Tax ID#: ys�IS- &OS, DO Y6 - 600- Lot No..
Site Plan Name: Block No.
Project Name:
:DETAILED:DESCRIPTION OF WORK: ,
1 i
Welia
I✓1
CONSTRUCTION INFORMATION:--
Additional
NFORMATION: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:$ I$9� • D Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:" CONTRACTOR:
Name ..^me--S Jac jol-, Name: Lo e
Address: ,Dai(o NW/ 40".%�el 0 a k Company: '•' 6 i ce 1�nt�e�
City: hC;+y State: Address: l SW Iil - i.. /t ve
Zip Code:3 P Fax: City: � SL �C is State: FL
Phone No. (77;51 336-h�" Zip Code: 3 Y9" . Fax:
E-Mail: Phone No 77 0-8LI R (o
Fill in fee simple Title Holder on next page(if different E-Mail A 0
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.
SUPPLEME(NTAL'CONSTlIkTION`LIEN LAW IN:FORiVIATION
D GIVER/ENGINEER: Not ApplicableMORTGAGE COMPANY: _Not Ap ' able
Name: Name:
Address: Address:
City: State: City: State:
Zip: Rw e Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable, BONDING CO NY: Not Applicable
Name: Name:
Address: Addr _
City:
.Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application' ereby mad obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commen prior to the issuance a permit.
St.Lucie County makes no representation t is granting a permit will authorize ermit holder to build the subject structure
which is in conflict with any applicable H e Owners Association rules,bylaws or an venants that may restrict or prohibit such
structure.Please consult with your H9Ke Owners Association and review your deed for restrictions which may apply.
In consideration of the granting his requested permit,I do hereby agree that I will,in all res ,perform the work
in accordance with the appr d plans,the Florida Building Codes and St.Lucie County Amendmen
The following building mit applications are exempt from undergoing a full concurrency review:room a tions,
accessory structur ,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-re ' ential use
"WARNING OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN PAYING
TWI FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDE
TED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
r
Signatur of Owner/Lessee/Contractor as Agent for Owner Signature o ontractor/License Holder
J
STATE OF FLORIpA STATE OF FLORIDA
COUNTY OF 5 , Lyc,%e COUNTY OF ' � t'-' c
The fgrgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
thislA day of c Dec 20_%1j by this day of p$c 20A by
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 tel, l— Produced
R�a•.X1L:�-
`\L\l DEANNAMARIEGNENS
Pill P.R1qFq1.qQ19P
(Signature of Notary Pub' -'State of Florida) (Signature of Not u rate tuber 16,2020
Bonded ThruNotary Public Undomeiiers I�
Commission No. EANN EGIVENS Commission No.
MY COMtASSION#GG 0220?S
r'16.2020 1�
. op, g ed-,h1Notary ubftUndervnuer: ;
REVIEWS Com; SOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19