HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:LI1 C� Permit Number:
Building Permit Appl
Planning and Development. Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
1y'(3mo
RECE EVI D
APR 0 9 2019
icle County, Pprmltting
Residential _0
a
PERMIT TYPE:
D IMPROVEMENT LOCA
Address: 6 Co Y J 'Z�) . - Ub - 01 , _ oTt
PropertyTax lD #: %l7i b`` i- —3 Lot No.
Site Plan Name: /��f Block No.
Project Name: �(,Ja m t r^A Q
I DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
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: $ GD1000 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name i v ebb
Name: iG
Address:
Company:
City�1-�. iPce. State:�y
Zip Code: ci, _` Fax:
Phone No. Ltl 3'0G-0 T19
Address.. w
Z
c�26� -ry
City-4tic�n 1rYM. State:?=cam
Zip Code: SYT.S-7 Fax:
Phone No 7i— O — 37?
E-Mail: NIA,-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 779- y%O ^ (T(s
State or County License i�� C� 16-19613
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGIN R:
Name:
Not Applicable
LL
MORTGAGE COMPANY:
Name: L4k¢ vital-enti�ia
Not Applicable
P� S'P f ✓1L�
Address: Deb
6*e-.2.61
Addres : 1 B
City:, �--'
Zip:'',` lFl¢L Phone
State:
JZ— S — 7
City: V IV^ ;,nI
Zip: 3 P114p�
State:
G �-
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 ols, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER. YOP14 FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMP Y S TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED T B S BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YO LE D N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
\'
Signature o ner Lessee/Contractor as Agent for Owner
nata'eofContr ctor ' eHolder
STATE OF FLOR1py� /
STAT F FLORIDA
COUNTY OF 7 / (� c i^�
COUNTYOF- . LU cl 'L
�
The t ng instru ent was acknowledged before me
this /�ay of a i 26 a by
The fRrggo,ing instrume t was acknowledged before me
this W�day of—A�n 1 20by
JQfT11-son 'IroLc)rltj
Name of person making statement.
Name of person making statement.
�
m O �`poco
Personally Known OR Produced Identification
Personally Known OR Produced Identification 6
Type of Identif��ccaa��on /lj
Produced it�
Type of Identif catioy
ProducedU t Q.r I �nS
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N Z N O W
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gnature o ota l+viv. tgf Flori ®E:
ignature of Nota Public- State of Florida)
Commission A 1313161404
"ora �s'
Commission No. Exp(k?November 16, 2021
�,/�
Commission No.�95(/) (Seal)
...... ` Bonded thru Aaron Notary
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
VED
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Rev. 2/7/19