HomeMy WebLinkAboutBuilding Permit Application/MU-0 3k-\G\5'1 ,
All APPLICABLE INFO MUST BE
COMPLETED FOR APPLICATION TO BE ACCEPTED �p 3aq
Date: 18 �G�llr(1 Permit Number: f�n11��W
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Applicationn�P�°P�d jOlo
�r
Commercial
PERMIT TYPE: 31f1G(,e FAMID( Ae5idence_
Address:
Property Tax I[
Site Plan NamE
Project Name:
Additional work to be performed under this permit —check all that apply:
'✓/Mechanical �as Tank _VGas Piping _ Shutters
V Electric Plumbing _Sprinklers I�Generator
Residential V
V windows/Doors
Roof Pitch
Total Sq. Ft of Construction: 6 3 TP,
Sq.
Ft. of First Floor:
Q O%cam
Cost of Construction: $ �BD�? I S• 1?i
Utilities:
�/Sewer _Septic
Building Height:
ODUNE /LESSEEc
-
CONTRACTOR: '
_- _ -
Name Willi
Name: 7-EPHEn D..'T�/17meL
Address: two 5c LoAmfinfwam
Company: CUSTQO/ SL
City: 1917M State: /_
Zip Code: 53458 Fax:
Phone No.I711/) Jf� 0 -7A
Address: y � ozq/l 16 /p _#.3 OE
City: � l,�'�` i�% State:
Zip Code: 3y99y Fear
Phone No —o1�d' �l
E-Mail: 11J77@ a0�.CO(11
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail m D ' . CO
State or County License C61,, 17 SQ
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.
SUPPLEMENTAL CONSTRUCTION
LIEN LAW INFORMATION
r '
DESIGNE
Name:
/ENGINEER:
K �tf^
Not Applicable
En �neeri
MORTGAGE COMPANY:
Name: TD 81
Not Applicable
N.fT.
Address: �1711 Caallle ffaol
Address: 0
I58
City: N e (Oou rn -
Zip: a935 Phone
State: FL
Sal- /o00-nr,�a
City: OLOn
Zip:, /�/g4— P�Sgne:�
State: 0
55- 6/92
FEE SIMPLE TITLEHOLDER:
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 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
TWI E FOR IMPROVEMENTS TO YO R PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSED ON THE JOB SITE BEFORE HE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOOIR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
L
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF /%/flier//%
COUNTY OF /Y/ R7 //�
The fotgoing instru ��yge ledg �efore me
this � day of /J 20 by
The for oing instru�lle i s edgedkefore me
this � day of ! ��K(/ 20�([ by
W61�/�� L • f{Uf1F
SrCOHEfI 7�• TE/nmEL
Name of person making statement.
Name of person making stat ent.
Personally Known r i a i n
Type of Identificat ry NW" Public Stew of Flo
Personally Known c o
Notey Public SYh of FWWO
Type of Identificati j.
Lori A Motdey
Produced ' on 2i 280148
Lori A Morley
Produced y-0�an fiG 280148
•NcF,.Jr
arm Expires 1112d1 M
Expires 11120R042
(Signatuy4 of NotaryPublic- State of Flori
(Signature f 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
DATE
COMPLETED
ev. 277119
Oakmont Custom Homes, LLC 9013 - ST. LUCIE COUNTY No. 12299
Job PO No Invoice No
1903 PERMIT FEE
Inv Date Proj Ledger Acct Reference Description Amount
02/10/2020 2 1400 1903 9012 ST. LUCIE COUNTY $275.00
Check No: 12299 Check Date: 02/10/20 GL Date: WC Date: At Date: Total Amount: $275.00