HomeMy WebLinkAboutBuilding Permit ApplicationJ
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number. 1 _1 W - 0d6 J6
RECEIVED
Building Permit Application MAY 07 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
St. Lude County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential J/
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: %Life e , Er o Pinzc Cjy-.
Property Tax ID #: I Ia- ,50o - 01 Q 9-e do - 6 Lot No.
Site Plan Name: Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
AAW flick ,cw 6AJ5CP*'69
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
K Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 9 0 0 Sj iF
Cost of Construction: $ 76 2 oo
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Lv d�A&cta#esr
Name:(' hv.j5rWaa -6 r
Address: 5-%S tc . eclo lam
Company: Dore' Pt76tS -EWC,
City: Lac t State: A-
Zip Code: � L%4 �� Fax:
Phone No. '.
Address: Rile 11t0' C+ • %A-Q-i-,•P.
City: V'eAro -6ea r Jr\ State:
Zip Code:_Ja-R b 7 Fax:
Phone No,-ia--UeD-aa40
E-Mail:
Di-27'AW' Vc1197 C's-C/'
Fill in fee simple TIME Holder on next page (if different
from the Owner listed above)
E-Mail (T .her VS+ ILA)3 Ca? C J✓LuI
State or County License RP alla 555z{lo U T
co-v%Li it 3 111
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.
a
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGIER:
Name: a -& tq
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:l3
Address:
City: avfw
Zip: 234%:z Ph ne &7bI-
State: �
304 2/38S
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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 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."
S' natur of Owne /Lessee/Contractor as Agent for Owner
Signature o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID►
COUNTY OF yAdl'&n 12%�«
COUNTY OF / ndi
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this Z day of /ho., , 20� by
this - day of 11 n x . 20_A by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification X
Personally Known OR Produced Identification kc
Type of Identification
Type of Identification
Produced `anc
Produced GLDL
(�} Eric Lug
Edc Lug
(Signature ryPublio- Sta NOTARY PUBLIC
tl�
STA E OF FLORIDA
(Sign o Notary Public-_ �V19t;
_STATE OF FLORIDA
Commission No. #GG145994
CommissionNo.G 9q G*m#GG145994
Expires 9/25l2021
e 1 ° Expires 9/25/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE,;
COMPLETED
nev:z/iy19