HomeMy WebLinkAboutBuilding Permit Application.a
All APPb.CABL0NF0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date: tiO��"� \dx Permit Number:
RECEIVED
- - - -- - Building Permit Applicat, n Planning and Development Services oCT7 9019
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 COI111'1'Iercial Residential
PERMITTYPE: s ��
OPQSED:IN.PROVEMENT LOCATION:
Address: 1Z,4=)
Property Tax ID #: 13®t — .601, 00 3 -' Wo — L{ Lot No.
Site Plan Name: Block No.
Project Name:
"pETAILED-DESCRIPTION OF 1NORK:
'. � � C��V S�v-mac..-�•` o � I S � J (-i- a�c,.�� _
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical Gas Tank _ Gas Piping X.Shuttersi< Windows/Doors
Electric Plumbing _Sprinklers _Generator V Roof Pitch
Total Sq. Ft of Construction: o? U`I i Sq. Ft. of First Floor: b
Cost of Construction: $ (196 '3 ICE . Utilities: _Sewer Septic Building Height: 16
'OWNER/LESSEE:
-CONTRACTOR:
Name l_�) L
Address: 33czo •fie• 16 t
Name:
Company: L L.C.
City: State: _
Zip Code: �� �d %: 33�a oZ`6 a-3
Address:33o0 Vk -ote, (o I
City: �o State: MC-1-
Phone No. '-C'I a -'LtS 3 1-1 3
Zip Code: �� 1-i,l� 3 (0 $a 3
E-Mail: L omn,Kotr.
Phone No 17a-Lt,.3-'
Fill in fee simple Title Holder on next page ( if different
E-Mai grei, • y`O
State or County License
from the Owner listed above)
If value of construction is 52500 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.
'SUPP,LLMENTAL'CONSTRUCTION�LIEN 'L
DESIGNER/ENGINEER: Not Applica
Name:_
Address:
City: —
Zip:
State:
Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
2MATfON_: ' -
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 jobsite
before the first inspection. If you intend -to obtain financing, consult with lender or an attorney before
comrrm.�jr ciri�''1�ry orXc or recording vour Notice of Commencement.
Sign atur o O ner/ essee/Contractor as Agent for Owner
Signature of Con actor/ i ense Holder
STATE OF FLORIDA i
STATE OF FLORIDA
COUNTY OF lark _C c ac
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 1:� day of .204 by
this _2L day of 20� by
Name of person m statement.
Name of person making statement.
Personally Known _�_ OR Produced Identification
Type of Identification
p,�,E,N ,ONOFRIO
Personally Known : <Ef ° pdu `C0M�1 y i=237558
Type of IdentificationS,Auyust5,2022
EXPIR
Produced
Produced` --^e�`
Notary public • •
(Signature of Notary Public- State of F orid )
— ature of Notary Public- State of Flo 'd )
{(AREN VONOFRIO
Commission No.�" E
' ;? t�rr)COMMISSION#GG23
EXPIRES:Augud 5, 20
Public tfid,'+rp.•'
,
.pPYPU' KARENpONOF
5� fission No. (5 ",' r2`'"' 1.&eapCOMMISSION#G
I :, ;,. :Q� EXPIRES: August 5,
REVIEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SEA f0RTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
z�I
DATE
COMPLETED
Kev. 9/21J/ 16