HomeMy WebLinkAboutBuilding Permit ApplicationAll AVICABLE INFO MUST BE COMPLEI'` POR APPLICATION TO BE ACCEPTED
Date: 1AA011z Permit Number: `�Ayk_GIA 1
Building Permit Application DEC 2 0 20j9
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
PERMITTYPE: S
PROPOSEDAMPRb
Address: _/ 1119 5 D/`E�4S/O FtL-"G /rf7
Property Tax ID #:
Site Plan Name:
Project Name:
I- . 3 4?45
Lot No.
Block No.
DETAILED DESCRIPTION;I FtW,ORK:ft
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: %U Sq. Ft. of First Floor: /M%Liv!.I JzD41)4rS
Cost of Construction: $ �• �r q N— Utilities: _ Sewer -(Septic Building Height:
�Y
OWNER/LESSEE:
CONTRACTOR`
Name 00f/W .S, irP041415
Name: R.Y`PH lr/��ty
Address: &,0
Company: li/lEGN;i7-1 46111-DEXS xrG
City: FT 19/EAeW State: rL
Zip Code: PhY2- Fax:
Phone No. 772, f75' d 9,9zP
Address: ka.3S5 /Jw r 44/ Al
City: cH/6,5� Stater
Zip Code: ` l72- Fax:
Phone No 772
E-Mail:
Fill in fee simple Title Holder on next page ( if different
fronAhe Owner listed above)
E-Mail �'CGN
State or County License
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required. oq 1415
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
� A o_ /11.a9 = ag0°llb
It I as 49• as 5l q b
fil! a�i6tilti- --
SUPPLEMENTAL COIVSTRUCTI
a a F EN+LAW INFORMATION
,,X;
DESIGNER/ENGINEER: _ Not Applicable
Name: 3e5,�51lt /, l9�Clr` 7r
MORTGAGE COMPANY:
Name:
Not Applicable
Address: fee ar, 015cG0llt 57
Address:
City: �7WA7' State: c
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: : ' Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
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 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature o wner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S% G UGiE COUNTY OF s L V o c
The f�o�rggoing instrument was acknowledged before me The forgoing instrument was acknowledge before me
this; day of !%G 20a by I this addayof VP¢ 204 by
/n•f/r S. %lP11IA1' Via\ t%VX• GrQca
Name of person making statement. Name of person making statement.
Known
Type of
PA10J.
(Signature of Notary Public- State of Florida )
Commission No. � 99109 (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
Personally Known OR Produced Identification
Type of Identification
Produced � %_ b L—
hignaLmc m rvuLal r.�'•• U+d I, COIO - GG022013 1;
Commission No. �i�1 . e EXPIRES!:"8 t! �denvide+e
BDndedlbm
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW