HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 `-- I D - 1 9 Permit Number:
RECEIVED
-- - Building Permit Application DEC 1 u 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300Virginia Avenue, Fort Pierce FL 39982 St. Luc[ nno,..
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: MUMMA --rW COnC/a-C
PROPOSED IMPROVEMENT LOCATION:
Address: iytiL Steepiecnase U, Fort Saint Lucie, HL 34986
Property Tax ID #:3321-502-0067-000-3 Lot No.
Site Plan Name: 9 04)tmaA�
I Block No.
Project Name: -FO0-1!MCLA
DETAILED DESCRIPTION OF WORK:
I. CONSTRUCTION INFORMATION: —I
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: $ 14
i OlJ 3 f / Utilities: _Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name John Fogleman and Anuradha Subramanian
Name:_
I�l t wM� n
Address: 7204 Elyse CIR
Company: loo"Y-5)(' Pn [C 11
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No.
Addre :
I(aga ksj Z., I-Ey�,t".P- CA
City: �, I c State: eL
Zip Code:13Li9W Fax: /M _Y(1Pa-(a
Phone No 0 - Y3a 3
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
,s..-,..- -ae__ ._ A—-_ - -------- -• -• -
E-Mail I/%i
0 t� anl�((C P/1 ✓i/tLSYI -GC{Y)
State ortounty License t�:)Cl l b(p<p�il
-
.. _____ wn„nencem",""qurrea.
If value of HVAC is $7,500 or more, a RECORDEDNotice ofCommencement Is required.
J
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ ENGINEER: Not Applicable
MORTGAGE,CONIPANY: �tApplicable
Name:QS
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone —
_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ of Applicable
BONDING COMPANY: of 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 concurrenry 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 IMPROVEMENTSTO YOUR PROPERTY. A NOTICE OF CO CEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YO TO OBTA FRIANUNG, CONSULT
WITH YOUR LENDER ORAN ATTORNEY BEFORE RECORDING YOUR ICE OF COMMENCEMENT."
Signat of• ner/Les✓ see/Contractor as Agent for Owner Signat' e of Contractoficens Holder li
STA E OF'FLORIDA STATE OF FLORIDA
COLINTYOF /f/{iQ7`//> COUNTYOF cf� �(c Gf
The for n ginstrument wa ac now edge ��ef re me The forgoin Y nstru nt w s acknowledge before me
this day
of 20 b this da of Cl L 20
c�/7/7 FOG/e/i7 � r Che.v l —F
Name of person making statement. Name of person making stat eht.
P t�
naI OR Produced Identification _ Personally Known l�Produced Identification
ype o Identification Type of Identificatio
Produced �J Prod ed
(Signature -of
ofAcitary (Signature of otary Public -State FI ri
4W. PWYOStMW Ot Flodtla`Nota PublicsCommission No. @ y GD 260146 Commission No aa1 q Lt Francene Ne
m
s 11r2112022 Aign Expires my commission2 2
REVIEWS
FRONT
ZONING
SUPERVISOR PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
N Hon~
1
221434
1