HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l '��• a��D Permit Number: smD
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RE
JAN 2 7 2020.
Building Permit Applica WPrmitting -Department
Planning and Development Services St. Lucie COLI nt FL
Building and Code Regulation Division �e
2300 Virginia Avenue,Fort Pierce FL 34982 !�
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: .0 l G
PRf7POSED IMRRQI(E'MEN l�C�?CATIC1Nbdi-
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Address: �2(PD Svp. .i 7aX c&,,, ei'J err �P� � 34' ?V!?LYa
Property Tax ID#: c;C f�P�ro ( �3S,(-J- Lot No.
Site Plan Name: Block No.
Project Name:
DETALER DESGtIPTION 43F WURK p ` x
r n xs +
e..� :^�. s
q, 1w" f «t�/ 7A fir_
CQN�TRUCTtON INFQRMATIC?N "' r _
Additional w rk to be performed under this permit-check all that apply:
echanical _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: $ Utilities: —Sewer —Septic Building Height:
W�ER/I.ESSEEr 3k u GONTRACTQR7 777; h
e., r.. ...,., �,
a m e 6 0 Name AJ e- Som Uaren<
k0ddress: 6
<5G;j� tr.Qrt�.. A&Aya.- Company: 114rev1c 5e,fV1 ce e.. ler, I LC
City:_Pyr k(wc,b State.4-1 Address: 3 4 30 C a-ru c-
Zip Code: 39!?4M Fax:38r- D l_lS_7� Cit _ 1-114 le- L
� � � y: Stater
Phone No. ` 05. '-;VQ:) , =59 Zip Code: 33013 Fax:
E-Mail: l � Q VF 6•'11 Phone No 30$ Cly ''37 Y
Fill in fee simple Title Holder on next page(if different E-Mail llc,Ye-^,c s�y-vice ycho c. c,o:-,
from the Owner listed above) State or County License C/+C__/ S/ d a
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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SUPPLEMENT
CON5TJF fC'ff EN l hW IN QRMATIC}l Y E n F &�x
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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: of 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
POST DON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
1 YOUR DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMEN MENT.70
C L L INIC�vi.CR�–
'Signature of Owner/Less ee/—Cd-MT40ctor as Agent for Owner Signature of Contractor/1-kens"Holder
STATE OF FLORIDAKcCli-I
STATE OF FLORIDA
COUNTY OF ( —� 'L COUNTY OF lQ GSI l 'bode,
The forgoing instru ent was acknowledged before me The forgoing instrum nt was acknowledged before me
this`Z3 day of GL01VGLt 20 W by thisZ3 day of JL1N vCE4 20 2,D by
Name of person makingstatement. Name of person making statement.
Personally Known K OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification RL
Produced Pr
ct►Ar°pe ANISHA ORTIZ-GONZALEZ
'?• Notary Public-State of Florida
8`- Commission a GG 918296
a' M Com
(Signat e�•"' '' #ary BtNI�IEto�illAWI9>'fAElOrid ) ( �"" orida)
Notary Public-State of Florida EZOZ`t 3�0 sandx3 wwo 0
`A P: Commission A GG 918296 m,„�y
aA►S � �:<
�_ uolssiwwo aa°
Co mi I'.. ct 1 2025 al) C a et5'• 7 (Seal)
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Bonded through National Notary Assn, Z3IVZNOD-ZI1 0"VHSIN'V'U
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW- REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19