HomeMy WebLinkAboutBuilding Permit Application1 .."!
All APPLICABLE INFO MUST BE
Date: . 16 ' Z
FOR APPLICATION TO BE ACCEPTED
Permit Number:
RECEIVEn
Building Permit Application OCT z s 2019
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: S ��
I?ROP(}SED.'JNPROVEMENT LOCATION:
Address:
ST. Lucie County, Permitting
Commercial Residential_
Property Tax ID #: -004- 00n �$
Site Plan Name:
Project Name:
Lot No. x e
Block No. 169
pETAILED DESCRIPTION OF WORK:
GO:NSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical _Gas Tank _Gas Piping XShutters
X Windows/Doors
�CElectric Plumbing h1 Sprinklers _Generator _Y Roof Pitch
Total Sq. Ft of Construction: /"� R i.V Sq. R. of First Floor: / 00
Cost of Construction: $ / nR On ru Utilities: —Sewer �{ Septic Building Height: t 6a
OWNER/LESSEE:.
CONTRACTOR:
Name 16_�)5 C
Name: lAlac �uA�est ��.
Address:33(�b £!;Tm •5ke.16(
Company: l9JJ LLC T
City: C��e Sbtx'e� State: _
Zip Code: `7q(0 F :3,2j a`6a-3
Phone No. i7a-L(53-i1(y3
Address:3&0 &"- cr" tc v PQP St2, (01
City: 6 state: NG•
Zip Code: a` 143C)ga-
Phone No
E-Mail: .DO
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mai d hph
State or County License C
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.
-#703A,
SUPPLEMENTAL• CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ?C_ Not Applicable
BONDING COMPANY: __yNot Applicable
Name:
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, fences, walls, signs, screen roams 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 i spection. If you intend to obtain financing, consult with lender or an attorney before
cornyaeoclug w or Eqording your Notice of Commencement.
Stanatul4g of ner/ essee/Contractor as Agent for Owner
Signature of ntra for/License Holder
STATE OF FLORIDA _
STATE OF FLORIDA
COUNTY OF Lac c P,
COUNTYOF S�-LVLC l e
The forgoing instrument was acknowledged before me
The forgoing Instrument was acknowledged before me
this .day of 3� 20_�J by
this 1 day of 20_a by
�c-�-V�•Q �A
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
END'ONOFRIO
Personally Known F • 'f? Nd pdt� END -ON FRIO 58
Type of Identification is st5,2022
Produced
Produced'-?ia SIR ryoyyp�uUrwundenMters
(Signature of Notary Public- State o
Signature of Notary Public -State of Flo •d• J
+;„Gd I EN D'ONOFRIO
Commission No. ;p: GG 237558
'._ AYCOMMI$Slfitl)0
�:"d'+'o. KAREND'ONOF
Commission No. :� :;x•'•"p"rOa,COMMIS510NifG
0
2.
F)(PIRES:Au9un 5, 2022
....o?' mNotyypullibUnder+Tters
��p$
+I+.:•,�Ei EXPIRES:Augusl5,
nd
r
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEA�RTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I
RECEIVED
j 3 LI
DATE
COMPLETED
ev. 9/26/18
L
553
tees