HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR A
Date: (RP-1
CATION TO BE ACCEPTED
Permit Number: / 0V3."
re-W _ - _ 6�155i RECEIVED
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Building 11Permit Application MAR 2 2 @19
Planning and Development Services Permitting Depaftment
,
Building and Code Regulation Division St. Lucie Countv
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X�C
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: &4VAE
I
Legal Description: 0 GD l'
Property Tax ID #: —AeZ '- 40
i
�,OD(J '•O Lot No,• 2/
Site Plan Name: 'V<Q
I Project Name: VIA
Block No. 4&4
Setbacks Front Back: Ri+
Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to a er
�HVAC Ei
orme under this permi�
Gas Tank Gas Piping
— check a
apply:
Shutters ❑Windows/Doors
LJ Electric ❑ Plumbing USprin I lers LJ Generator Ll Roof _Roof pitch
Total Sq. Ft of Construction: 3,(OOc..Pr S . Ft. of First Floor: 3.690.fP.
Cost of Construction: $ /✓ ?3 066 • eo Utilities: _ Sewer [] Septic Building Height: �r—O !1,
OWNER/LESSEE:
i
CONTRACTOR:
Name �%�,4 GVi1,P4 A/1�,lilililf,�
Name:
Address: //,00 69k/_
Company: /Gfi 11,/j X,, myf awxr aw,-�p
City: State
Zip Code: -69 3 7/ Fax: 4114
Phone No. 32o--7�J��7� I
E-Mail: (/e��s� GGa1/rJ/'�f-CO/n �
Address: l06
City: zagr �IE.dGE State: �L
Zip Code: 3 Fax: 772—�0-7665
Phone No. 772�1�d1 g3�j
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: /^D/^/�17 /"it'Dll///�
State or County License:
- -- - -- - --- -��� �• •�nvnur-u 1Vozice or 1-ommencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
I
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: �L�l�L !�i%�GG��//VG• I
Name: AAA
Address: /9�L/ Sl- e// I
Address:
„�OQ�
City: )5ba rJ,61k State: �'�
City: State:
Zip: ! hone >-7 5-9Q �
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
_
Name: AIM I Name: %V
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I
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 prio 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 Associai ion 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 fro undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sign , 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
commencing work or recording our Notice of Commencement.
�, tJ�
i re of ner/ Lessee/ ontractor as Agent for Om)ner
Signature o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST f;//Y�/�
COUNTY OFs
The fo oing instrument was acknowledged before me
The forgo' es� instrument was acknowledged before me
20[6 by
this day of l%�G 20f� by
this ,fay of �I/I�QG
Name of person making statement
Name of person making statement
teraso2nally Known OR Produced Identification
Personally Known >-< OR Produced Identification
Type of Identification
iypeoticientification
Produced
Produced
4_1 XZI,0�2!�
(Sin ure of Notary
(Si n re of Notary•Pub ic- State of Florida)
ROGER A. PRIEST
Commission No.66otopMoblic - Slate of Florida
ommission N a ':,"''•� ROGER C�� .V'
� a'Of,Publiv-
COMMISSion N GG 010T10
XTZO
Slf1aa1 §W16d
yComni. Eaplree Nov 7, 202
AsREVIEWS
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FRNG SUPERVISOR
PLANS V i E
,
COUNTER VIEW REVIEW
REVI REVIEW REVIEW
DATE
RECEIVED
j
DATE
L�1�
COMPLETED
Rev. 8/2/17