HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST B OMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit NumberU V2 1`11'�L
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: ALO tl l om Pdot9- SC(UEQ CI,)CLOSU(i.£.
PROPOSED IMPROVEMENT LOCATION:
Address: l-I111 OIL). S1,JL£TBA`f CAE ' N_L_h CIT`t FL. 3L(990.
Property Tax IDf#: Ljq26-9011-cyio-000-O Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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GONSTRUCT(ON 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:
_
Cost of Construcfo'S(�(� Utilities: -Sewer —Septic Building Height:
OWN -R/LESSEE;
GONT-'T- R:
C. HAlWs'
Name: '-lDDOLR FIND
7Namerl3LTE2
I Ll 9 t A JA J.- C Qf—_LT8A,-J C I
Company: " CC
Hy: PAL (�T l ' ' ;', State: f[�
Address: 2`18�i S•£. C,2�iJ[1
City:FLhneNo.
(Address:
Code:3"`Cl/��Q Fax:
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Zip Code: 2LACtKZ :'Faz: 't". -
&Mail:
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PhoneNobq)lZ DUL-SRG t
E-Mail Fi X JOS SC fL[ £ 0 a ATT. QLT•
Eil rMee simple Title Holder on next page ( if different
State or County License
from the Owner listed above)
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.
CD.
U PL M - TAL CONSTRUCTION LIEN W
TION:
MORTGAGE COMPANY: _ Not Applicable
Name:
DESIGNER/ENGINEER: ' _ Not Applicable
Name: PAUL WLLC 1A
Address: 1cl 1 C3�t1 MOCLL
ST #r I ly
Address:
City: PD(LT sT LtX (S
Zip: Zq SLi Phone )
State: _EL_
'iSs gB89
City: State:
Zip: - Phone:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
BONDING COMPANY: _Not Applicable
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
WITH XAZaRLLENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Si go f Owner/ Lessee/Contractor as Agent for Owner
S' o tractor/License Holder
r
STAIE
"OF FL
COUNTY OFORID�1IL- ,V_
COUNTYOFORIDA.S.fi WeK_
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this —1"7iay of IV A—r � 20 U-)by
this fj L day of M/dr 20_2b by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
�fl�
Type of Identification _
pt�VDL'
Produced
Produced
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(Signature of Notary Public - St to of Florida J
(Signature of Nota
ELL N VAUGHN
°`t,;State of Flgqppde-,�J otar Public
Commission No. ,..,,,,, EN VAUGHN
�e4;5
mmission No.
ommiseldP4 GG 270079
State of Florida -Notary Pubic
%?a� My Commission Expires
anm" 2022
My Commission
Expire
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Rev.2/1/19