HomeMy WebLinkAboutBadawi PermitSUPPLEMENTAL 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:
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 Dome 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 5t. 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 YOUIR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_"
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Signature of Owner/ Lessee/Contractor Agent for
as Owner
Signa ure of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA r,
` - "
COUNTY OF a CA 7:
The forgoing instrument was acknowledged before me
'( fl
The for omg instrumenty+as acknowledged before me
—f
this day of 2d2 by
this day of Al,ft 24"14 by
me of person ma kinstatement.
Name of person making statement.
Personally Known _VOR Produced Identification
Personally Known 4—f}R Produced Identification
Type of Identification
Type of Identification
Produced
Produced
natur of Noof Florida }
(igna re of Not Public- State of Florida)
Com fission No.=(Seal)
Com fission 5I) hh CRAWF(iR
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: fl 1 fZ02_0 Permit !Number:
RM
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 452-1578
Building Permit Application
Commercial Residential
PERMITTYPE: EC70
PROPOSED IMPROVEMENTLOCATION,
Address: l td1'1 2 C I rf 9 6 6 -T
Property Tax ID #: 532 41 "ooL13 -'00(9 Lot No ----'I'S
Site Plan Name: Block No.
Project Name: rA ocC , c� .� QQVJ 1
DETAILEDDESCRIPTION OF WORK:
�nS- -r7�11 Se_1 jf oe vD_A tit
CONSTRUCTION INFORMATION:
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Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing
r� Sprinklers _ Generator Roof _7kg Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ _71;/()()(D Utilities: —Sewer —Septic Building Height:
OWNERf LESSEE.
CONTRACTOR:
Name_m�
Name:
��W
Address: o9 �_ _ C.Y� �• ..., 0��1
Company: a vie -
City: L) (""k, e State: FL
zip Code: V98(v Fax:
Phone No. ) 12 " 21 (0 - Lib l S
Address: I _SF_ le&
City: yfi State:EL
zip code: y I _ Fax: " - Z91 -_776
Phone Na - Z$ - 2.
E -Mail ?Q -CYN\ CC7Cj `10 QQ e- i(-'$
_ -
E -Mail: riP! cis QAY\0n J 16 0.n'i"14��j, C v+rs
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
State or County License CCG
a value oz construction is !>lSUU or more, a RLCORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.