HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETE'_ JR APPLICATION TO BE ACCEPTED
Date: 3`y �� �C Permit Number: a`dd3' od�3
0
(Oc3" >5 RECEIVED
Building Permit Applic tiorhAR o 4 20z0
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 5sx,1_
PERMIT TYPE: �Si,IL, Qs,cWe_n-ho—L
Address:
Property Tax ID #:
?a2 � 00/0 —
Site Plan Name: L:'-9 Z c ef&)
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Project Name: /i'l o ra U i itd 0 5 i ct2 }�i-I /1 SY / I A
Lot No"W4SY
Block No. l IA
y `�
,GONSTRUCT�OIVINFORMA7'IORI,'~
zY
Additional work to be performed under this permit — check all that apply:
t' Mechanical _ Gas Tank _ Gas Piping ✓ Shutters
Windows/Doors
Electric ✓Plumbing _Sprinklers _Generator
✓ Roof 6//Z Pitch
Total Sq. Ft of Construction: g9-kot J' Sq. Ft. of First Floor:
1.� Ild
Cost of Construction: $ tl )a-e,(r_ Utilities: _Sewer d Septic
Building Height: /7 r /o
Name ��v�o.� 1i aw., 1t(nt lrw,_,c;c+ _ I .LL
Name: (�ie.ix,7(%Il n/IC TE
Address:Jc'%ZS�d lhi{ e1eojn 171v.11ilk
Company: &r\e,_Y i��;Jr(c�215 Li,C _/
City: Cri ,a State: Ft
Zip Code:�—�Fax: "77.Z (_"i A. ii ,Sa
Phone No. I T) _ f.eid 7r�CJ%i
Address:1172_ 5 Efi S-F Aeo4 r, '31/a S •t ,L tD
City:State:'_FL
Zip Code: T J% Fax: '7 %.`lam 1,01 _q.c'li:S..
Phone No •77---(,,�)-Z_ Were
E-Mail: ICi-101,DAP'JQWL e ,.ezrM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail P .ti, 1D A i.zzvF, (' p� i= /J frr; 4,6ynes
State or County License e13C
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.
I
&URPLEMENTAL CONSTRUCTfON LIEN L. INFORMATION:'
^
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: _Not 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 represent tion that is granting a DDermit will autjtorize the permit holdef to build the subject structure
which is in conflict with any applicable Home Owners Association rules, byllaws 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
0�". /-P, ICY/
a- gw'gE
Signature of wner/ Lessee/Contractor as Agent for Owner
Signature of contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S-� L u c4 e_
COUNTY OF -r1- U iP 13C
The forgoing instrument was acknowledged before me
The forgoing Instrument was acknowledged before me
this � .y! day of / ei cat i 20 ao by
this a. day of March 20 70 by
.YA__ _ /4 _ I
--c�JeLliin lI
_-
ame of person+ making statement
Name of person ma g atement
'kih st
Personally Known ✓ OR Produced Identification—
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
J
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
5
DATE
COMPLETED
Rev.8/2/17