HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Bate: Permit Number:
P
I
9 �
Planning and Development Services
Building and Code ReguIntion Division
2300 Virginia Avenue, Fort fierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building P8rr at Appkataon
Commercial Residential
PER�1i°IiTTYPE:. I/ 60 (l (+�t$ kms/
PROPOSED I nbvEMENT LOCATION:-
Address:,�--ff,, U 1
Property Tax ID #: 4a -a 5 i I) bc)c 0 D CP Lot No.
Site Plan Name: ('1'� t 1 Block No.
Project Name: f e LaJif rve
DETAILED DESCRIPTION OF WORK:
I CONSTRUCRON INFORMATION: I
Additional work to be performed under this permit —check all that apply:
Mechanical Gas Tank Gas Piping _Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator r Roof Pitch
Total Sq. Ft of Construction:
Costof Construction: $�
Sq. Ft. of First Floor: —
Utilities: —Sewer _Septic
Building Height:
OWN ER%LESSEE;
CONTRACTOR:
Game I !
Name:&i
Films PM,
Address: DC7Ren C R
Company:
_
i lei yi FL--
M
City: state: &—
Zip Code;303a LD .� Fan:
Phone No.
Address: �Ot� !L
� "I r ij Pll a a 94-7
City: W R A
'Zip Code: l � �
Phone No J >?Cr
J State:
Fax:
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail n.t �Lri
r—.
State or County License Cl�1c k C� 1 �i if C-
if value of construction is Sz5o0 or mare, a KtLUK1Jt1J fvolace or t-ommencemenL is reyuMEcu.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 IMPROYEMENTS 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 YOLK! LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Rev. 2/7/19
l
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of C ractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY 0FPAI.MBEACH
COUNTY 0FPAtMBEAcH
The forgoing instrument was acknowledged before me
Theforgoing instrum t was acknowledged before me
thii gday of � -1 �J 20_ by
this l day of rt 20� by
RORY RAMCHARAN
RY RAMCHARAN
Name of person making sta Notary PubhoState of Ronftrae
CAMILLE AU-AMRAT
of person making state nt.
ty
GG 97i>8t39
Personally Known X e�BA
rsonally Known X Q Icil0&111mctFrorida
ALI-1
Type of Identification `�'
pe of Identification Mp Co+nmissian GCs 97t39ti9
Produced
Produced EXOMS 03r3or2024
2
(Signature of Notary Public- State of Florida }
(Signature of Notary Public- State of Florida }
Commission No. FF976919 (Seal)
Commission No. FF976919 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLAINS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
[SATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19