HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLe CED FOR APPLICAT.16N TO BE ACCEPTED
Date: ��3U�i �'G��U d��� - cw i� Permit Number:
- Building Permit Applical
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial V
PERMIT TYPE: o&h Wa,7—i hn
Add
T � n
ion MAY 2.2019
Permitting Department
St. Lucie County; FL
Residential
Property Tax ID#: .341AR - C)VO/ - 05'O-.2 Lot No.
Site Plan Name: Block No.
Project Name:
6.,� -1 - -�—
TvwA. J�/l vH,v-
_�41
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator, _ Roof, Pitch
Total Sq. Ft of Construction:
5ODO
Sq.
Ft. of First Floor:
Cost of Construction: $
roos C7f7
Utilities:
v-Sewer _Septic Building Height: /4'
OW ER/h SSEE€
G�NTRAGTOR:
Name /c t7 v ..z e- LyNGv1E-
Name: (fJJot ,><- ' i,DALtS
Address:4212W
Company: C0.95s Tv CvnS.- gcrc
S e,- F
City: %00w 7 State: /r./
Zip Code: 3`%9SZ' Fax:
Phone No. 77.z-.
Address: V93S S')Tif .0K
City: V6�O BC9C!/ ' :
Zip Code: :�ft 7 Fax:
Phone No 77a- 560-?)6!�
State:
E-Mail: f'a��zccft�vei�E���B«cSv�7//NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail C6:g g ��L cS • CO 62
649ASL • LoM
State or County License CCiC /50'FV�
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.
SUMILEMENTAL GONSiR IN
LIEN LAW I[dFORMA
G
DESIGNER/ENGINEER: '•. _ Not Applicable
.�
Name:«)
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: r19,29 5- x,7ys7J
D%rvc
Address:
City: C-7 P,1 2rr
Zip: 79'98,2 Phone 777-1,
State: FC
g/ - .5709
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name: kzNa A> ?za
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 369 Sad ivun711
Address:
City: 1eje7 5-7 LVCzr
City:
Zip: Y M. Phone: 77? -
370 -- 9900
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a'permit to do the,work and installation as indicated.
1 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
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 LPWiERWAN ATTORNEY BEFORE RECORDING_COUR NOTICE OF ENCEMENT."
Sigria,t o Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY
COUNTY OF Irdil n r2.A j)p`
OF IndtQo Q,%.`1Q$
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this I day of Mat 20J3 by
this of �i�, 20Jq by
%day
Ur
�1:QC
Name of per on making statement.
�1?6trf' Lnl'1eVO
Name of pe son making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification ✓
Type of I entification Produced
Type of Identification
Produced"—
0 �e
LigLKAflLABOLES
NN.otary Public, State of FI
mission# GG 2451
r'
7(Si a u e o Notary Public- State of Florida
, 2022(i missionNc ' ea
na reo otaryPublic-Strida-}—� -
VCommission
J
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NQ>�n. fo �A7 (Seal)
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ZONING
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Rev 2/7/19