HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE C&'virL'ETED FOR APPLICATION TO BE ACCEPTI u `
Da 31SI a,a Permit Number: a �03' o \ 53
RECEIVED
-- - - -- Building Permit Applical ion MAR 0 5 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: atil (;--q _ w•\ ,zS 'h} a' V.
P.R� MPMSEDI I M 12,11-0,VEM ENifiJ= 101
Address: I l O! rp KJ A I NO W RG (4 er((' FC 3 of q'S Z.
Property Tax ID #: � qo ,r T — So /" 022 I — 000 — 0 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION Of WORK:
/-eg" c-e- 28�- (t)I/U ov:ws 4o ffoirrl`caNimpact PSIS N
P,e40ce 3- Fi2e/VCh 'Doors 40 Xrr(6g#Ur Title
CONSTRUCTION IINFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ Z / :�00. Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CO TRAC OR;
Name rdt J010 ame: JOSS M. s %J gZ
Address:c� HOD W Nil w4y 'rot Company: _ !1!lS�..�OL`C,f�'QC{O-h� oroyp
City: "'rr:""^"Plc�e� Ma,. ! State: FL Address: ii33f 1 P
Zip Code: ll g'�' °'tFax: ? City: 0,6k- a-Aq"(1 �Pci'C� '�,'`T"r5tate:
Phone No. i90Y`°St3679`I9e, Zip Code:
E-Mail: ` h&PW ' 943 �� 9M CIS Aid �_ Phone No 340S vjtpQ F3J t7 �
Fill in fee simple Title Holder on next page ( if different E-Mail JMSCON'tMC'40619 rpvP (5—)) (0M4fL,(T0AA
from the Owner listed above) State or County License C WG 1$ ZIC"I ZO
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.
' T`. .
DESIGNER/ENGINEER:
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not
Name:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City: City
Zip: Phone: Zip:
OWNER/ CONTRACTOR AFFIDAVIT: 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 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. IlkYOU INTEND TO9BTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY.BIiFORE RECORDING Y0NOTICE OF COMMENCEMENT."
as Agent for Owner
STATE OF FLOR
COUNTY OF C�
The for oing instru e t was acknowledged before me
this day of f 2Q7�0 by
,lf/i)4/1t.1� G r�
Name of person making statement
Personally Known (/ OR Produced Identification
Type of ld nt fiicati n V a ` 0
Produced ,� aao - 0 99 - s- Y'
(Signature of NcA9I1r
P+""�rOry•NoPu61ie SMe a Fbdda
Commission No. Oorathy Jeann BBIGtSeal)
S �n e.oi..10/10=23' ""a
REVIEWS I FRONT
COUNTER
RECEIVED
DATE
COMPLETED
Signature of Conikactor/License Holder
STATE OF FLORI
COUNTY OFF ('�
The folg_oing instru en was acknowledged before me
this 7 day of (� . 206Q by
Nb�ne of person making statement. 11
v/
Personally Known OR Produced Identification
Type of I entificatio�P 9
Produced • _ • .7 araa '07_,
(Signature of Notarblic- State of Florida'.)
Commission No.
My
RENING VIEW' W I SUPERVISOR REVIEWI REV VIEW I VEGETATION,
I SEA
RE
EW I REVIEW