HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ?
Date: ICJ QJ1 I F Permit Number: V
s, _ :IJ..- f_ RECEIVED
o d F.°. 7E �� ��`
- Building Permit Applica$� DEC 2 6 2019
Planning and Development Services j og F� �_ � e Fr -CC- Sr. Lucie County, Permit
Building and Code Regulation Division C.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:
Address: 3 2I1 Sttel
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Property Tax ID N: 17y 2-9- b of —O o Z/ 4 — O 00 •-c) Lot No. z1 sS0'
Site Plan Name: '�9 GG 4 566 7'Z' A Z Block No. I
Project Name: &00VP4z¢ G%iCw�l`t(% �LxnT[jo7Qd a'ctlLewe h AeC_e-5S"
Additional work to be performed under this permit —check all that apply:
Mechanical
_ Electric
_ Gas Tank
✓Plumbing
Total Sq. Ft of Construction: 3 3
Cost of Construction: $ 5;660 � DD
Gas Piping
_ Sprinklers
Shutters
Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer ,Zseptic
Windows/Doors
_ Roof Pitch
Building Height: g
9 �r
OWNER%LESSEE.,
CONTRACTQR: .. - • ,-
Name ec1 S G...ee2- r' R�sn�Jt
Name
Address -Ws V1M%r)b i=yr '5t IILA
Company:
City-F'bfr rpuc C PL • State •
Zip Code: 6—ts'ia Fax:-1')2_QiPS°J?(00
Phone No. 1—I2- -ICES' gIO(o,
Addressaa 1 Vi rraiclo -P-V'r
'
City: State: F-.
Zip Code: 3LAI Fax:
'Phone N.-1 — —
E-Mai QrlTGtLQl tGIn
fI •
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 17 �i
f C
State or County License
It value of construction is 52500 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.- '
DESIGNER/ENGINEER:
Name VYARn �V
_ Not Applicable
o P_ C
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: -112-1 NW IW�c
CT
Address:
city: Pe hr %1o✓DK-6 QIFYRJ
ip: Phon
Inamer
State: FL•
1 1S uC�
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 Assocation 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
dau-6, Aalvom
Sig of Owner/ Lessee/Contractor as Agent for Owner
'g ature of Contractor/License Holder
STATE OF FLORIDA -
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ATE OF FLO DA I
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COUNTY OF t - LALA CI
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The f g instrument was acknowledged before me %
47 day L&_e_YY�1� 201q by
The jQlgoin Yinstrl menty� re me
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Name of person making statement.
Name of person making statement.
x
Personally Known OR Produced Identificatio!y,'`' yea
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Personally Known OR Produced Identification V
Type of Identification : t
Producedl oN"sto,
Type of Identification
Produced pY}VicYl$ l oemP
(Signature bf Notary Public- State of Florida)
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(Si nature of Notary Public- State of FloridahWRAI
Commission NoO'tb -'I (Seal)
Commission No Gi bi c12 b53 (9a . Commleelo
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.Z///19
92000
21202