HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a0 Permit Number: aOd3 dO�y
RECEIVED
Building Permit Applicat on MAR 0
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 5cx5c
PERMITTYPE: ',, lu QR_,-io(e_n -ho_,
Address:
Property Tax ID #:
Site Plan Name: A --m /.
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Project Name: MoP_ti GSr cLv (I A
Additional work to be performed under this permit —check all that apply:
✓ Mechanical _ Gas Tank _ Gas Piping ✓ Shutters
✓Electric . ✓Plumbing _Sprinklers
. Generator
Lot No. Owq("02'
Block No. P910
VFW i ndows/Doors
✓ Roof /,h2— Pitch
Total Sq. Ft of Constructior}� Sq. Ft. of First Floor:
Cost of Construction: $ /03 C°00 , ao Utilities: —Sewer J Septic Building Height: (- i 10 rr
h01j1/ R ESS " s i tF t �f a t, fir}
xtm Y�Ps ia' i"z
CQNI R/�CTOR U v
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Name PieancLr atn dx
Name: LYt 2V�Y� t�V12n lI� �[
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Address: J��j7��5� c- a:4 /)C�4e, Alv,l clra-
Company: �nar 'BLii (r�- eYS U)C/
City: _ k5 _1 ,, State: ;r:'I—
Zip Code:'149 54 Fax: '772r / cl ol. 91 Sam
Phone No. IL),
Address:aV 5 8k-A neon n �&A Sv k_ to
City: �, � � State:' FL
Zip Code:',-14'79 6 Fax: 'I7._&0ia.g/
Phone Nqo
E-Mail: Ri-ra..r6a[,LDW=- Ce �rAyij z,9rCam
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail )&M .J0AP0_6zy8 P� Aj W� a/nyylt g
State or County License G'/3e. 1o2ie i o2 .qk
If value of construction is s2500 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.
Address:
City: State'
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not
Name:
Address:
City:
Zip: Phone'
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone'
BONDING COMPANY: _Not Applicable
Name:
Address:
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.
the permit holder to build the subject structure
and covenants that may restrict or prohibit such
red 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 IMPROVEMENiS 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCENEU ° i
'14,
A 4A
Signature of nrner/Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OFF ORIDA
STATE OF FLORIDA
COUNTY OF 2S4- L 1 Ge_
COUNTY OF S� LJC1
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 2 dayof i'f1r�rrCh 20wby
this Z day of MWQC*G , 2070by
LisA, m - iri
C,4.Q r,,., A—DAyl e 1T
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known L�'_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
OWE
io�°'a: nue,,� RH NDASRGWE
Commission#GG 104656
ati>ar aaa`c
° ' Commission#GG 10465_LW6
ah, Expires May 19.2021
Expires May 19. 2021
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�� ,nzem nuaaet Nolary Servkas
(Signature of Notary c- Sta e o lorr_ a
(Si nature of Notary u Iic- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
5
RECEIVED
DATE
COMPLETED
ACV. G1/117