HomeMy WebLinkAboutBuilding Permit ApplicationAll
Date:
E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ✓� ZO Permit Number: -7 2003 - O 0 4/
Building Permit AppligbtiONAR 31 2020
Planning and Development Services ST. Lucie Coun
Building and Code Regulation Division tY, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential J/
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: SZ acxa l Ln eovk 31• 3�952
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit -check all that apply:
✓Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
V Electric ✓ Plumbing _ Sprinklers
Total Sq. Ft of Construction: Z OD
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ \,k �`j, 00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KKOA O�T-el
Name: a.
Address: 1, 't- l Q�
1
Company: Amkan Mav�ao�eryJ�QN�
1
City: �I vaX IRUVA. Stater
Zip Code: -,53 U 6( Fax:
Phone No. 176 - Z5 Z- 5Z/ O
Address: SW I f)0 ANA- 1sL
City:tntim3nAw State:-R.
Zip Code: Fax:
Phone No — V 1'1
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 1Y1as10Q1YYlQI✓ ow ,
State or County License C IV l2b15 68
If valve 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.
U
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: 9temnn %• VhOpdL
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address: aS0 sW Sv\iy\n
16C
Address:
City: \ Qo $c:.r�,v (,\-2
Zip: ?au qS3 Phone 1,)'L
State: _
)?, l7624 _
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Nagle:
_ 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 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, feriSes, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE -TO RECORD A NOTICE OF COMMEN MENi MAY RESULT IN YOUR PAYING
TWICEFOR1 ROVEMENTS TO YOUR PROPERTY. A NOTICE OF CO M CEMENT MUST BE RECORDED AND
POST ON T,j1E JOB SITE BEFORE THE FIRSY INSPECTION.IIF_ YOVJ E TO OBTAIN FINANCING, CONSULT
Wf1VI OUR'LXNDER OR AN ATTORNEY BEFORE RECORDING R N CE F COMMENCEMENT."
Signatu f Ow r/ Lessee Contractor as Agent for Owner
Sig to ifrac r/License Holder
STATE O FLO ID
STATE OF FLORI A
COUNTY OF
COUNTY OF/ d
The for o'ng instr ent was acknowledged before me
The forgoi .instrument ways acknowledged before me
'V�y
this' day of rrin 202(j by
this of Aft rf—k4v 202Dby
e'
;1, 4P i Relfial-d
, t
Name Of person making st ent.
Name of person making sta ent. ; `
Personally Known ORProduced Identification
Personally Known OR Produced Identification
Type of Identification
Produced-',
Type of Identif on
Produced a � 1ie ic4,I P. t/ jam•
r
;,
f
(Signature of Notarybblic-
(Signature of Notacf Public-vl
�MS1PIelD
Ibh Pulboo mclntd.
Fammildiin.C�OIROtId�
Commission No. C017�1�M
EapYmi *2269"
Commission No. �DmtVts 8t�@4
�23,20M
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19