HomeMy WebLinkAboutBuilding Permit ApplicationSite Plan Name:
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ti \. Z� Permit Number: Za03-oZ03
RECEIVED
Building Permit Application MAR 112020
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 1C
PERMIT APPLICATION FOR: To Select from dro box, click arrow at the end of line
I PROPOSED IMPROVEMENT LOCATION: -J III
Address: r1103 Wiv1ler OokyAerl I>YW\1 Ptt,✓�{- P>; ercef FL 3yg51
Legal Description: L%lCeWobel PoWk UrIii— 11-- 131-I4, 144 IVf5 II 3 1 Z (0.4 4 Ac-
11311 SO rtMAP 13)12 r4) (W 39D1}_143bi 4ZbL1 -ZZ520
Property TaxlD#: 13bl-to) 3 Lot
Block No. iVq
Project Name: Oi 11 egP12 -C-WI)tZTS AA W1'12. V2.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: III
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CONSTRUCTION INFORMATION: III
MUU1L1UnaiwUrnw Ue cnununu UIwoi uua Penun—LUMN au aFPiy.
11HVAC Gas Tank E]GasPiping _Shutters ❑Windows/Doors
11 Electric 0 Plumbing OSprinklers 1:1Generator Roof Roof pitch
Total Sq. Ft of Construction: I ZI00 S Ft. of First Floor: 121ab
Cost of Construction: $ 19 r59 2 Utilities: Sewer Li Septic Building Height: {b Io' I ?✓
OWNER/LESSEE:
CONTRACTOR:
Name P41Y1C•14
Gil es ie
Name:%iV12S l
Address: 7103 Wi✓Iter rdev► nLw-)
Company: WIPA-t7
tJY2.
City: For+ pierce State: FL.
Zip Code: 340151 Fax:
Phone No, 352-4to$'llll0
Address: Y•04N 7l(p
City: ei'wyn
Zip Code: 320011
Phone No. W-`iWO-1111,D
S``t�a�te:Qt7L
Fax: 352"110�-111®3
E-Mail:�iop YVl'\1'151171 gmziI•Corn
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: 50p$YYrlli-s;
I
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11'lal I CoYY1
State or County License: C
0I70�)10195
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
9U h
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 Count 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
STATE OF
RIL ev.8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatur Contractor/License Holder
STATE OFFLORIDA..al�t LUu�
COUNTY-- ll��
COUNTY OFORIDA
The for oing instr ent was acknowledged before me
The fo�oing instrument was acknowledged before me
this 20?�by
th(s day of �4RGl/ 202Dby
I���dayof�On-1�
`�UTf I uG C71i
LJ/i-MES �t.4yr�
Name of perspn making statement
Name of person making statement
Personally Known VV OR Produced Identification
Personally Known A OR Produced Identification
Type of Identification
Type of Identification ,
Produced
Produced
(Sig ature of No
(Signature of Not-
Commission No.
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_ • �_ MYCCIMM (+�+ OOB459
"ai�••., MARIAR.BURGIN
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Commission No. Commisslonp6Q$�3!]3
E7(P1RE 'Y7 2020
•: ,� 's, Bandedthru Notary PubGoUndenniters
` Expires August25;2023
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