HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-25-19a
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
J
Building Perry pplicatioln JAN2 5 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie COUntV, rcrmitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 'Commercial Residential
PERMIT APPLICATION FOR: To Select frolm dropbox, click arrow at the end of line
Address: -#A)f 4fA-
Legal Description: Sv,?eq PRJ 601�) at-�--4
Property Tax I D #: 144— -7b4-000.31,- 090 �G Lot No.
Site Plan Name: Block No.
Project Name:_ Ad2o./AV157A
Setbacks Front Back: Right Side: Left Side:
&01L,9377?-0 C77 0 AJ
�4
Additional work to b ertormed under this permit— check all apply:
allVAC n Gas Tank [L]Gas Piping Shutters Lawindows/Doors
aElectric aplumbing ILI Sprinklers Gefierator Roof Roof pitch
Total Sq. Ft of Construction: 7-4/0 S Ft of First Floor:
14sewer []Septic Building Hei . ght:
Cost of Construction: $ Utilities:
Name A0A410V0TW-A,-,-7-01U UC,-
"0 644AOD
Name: 06
Address: 4100 PJ 0,A-6LEY-Z I ST
company: 08AI-POOLI46J40 RK- 1r)e,
City: M4 A-"( State:
Address: �f3-7 901,10-947 /51�O Afy,�-15f=
City: JJA&1L-A-,-JDAC,5- State:
Zip Code: 331 4�-t Fax:
Phone No. YTz- - qf
Zip Code: Fax: —
Phone No. '4R 6
E-Mail: V',O�ek A-V /. "I RP — <20
Fill in fee simple Title Holder on next Oge ( if different
E- M a i 1: V11 r4",? �W 5�� AWY-&,5- a07,0
State or County LicYnse: 04;e 04;-4-:2-07
from the Owner listed above)
IT value ot construction is SZ500 or more i , a RECORDED Notice of Commencement is required.
�,'�amt'NTAL Q0N$T t 0i RK'
r
..........
DESIGNER/ENGINEER: NotApplicable:
Name: 41 1
MORTGAGE COMPANY:
Name:
'—lq—ot Applicable
Address: .20 02�7�PAW P0
1A:VV7 S&17F,�*)l
Address:
City: L/-Cj'-"0 OC State: r4��
Zip: '32!5!6o Phone ')92 — 17 — "—sr"S—
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: --Sf-N'ot Applicable'
BONDING COMPANY:
--'N-ot Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is herelby 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 alpermit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Associatibn 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.
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The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs,iscreen rooms and accessory uses to another non-residential use
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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 obtai I n financing, consult with lender or an attorney before
commencing work or recording vour Notice of Cbmmencement.
Sign k� e 4-Owner/ Lessee/Contractor as Agent for Oviner
Signtre o Contractor/License Holder
STATE OF FLO!!��
STATE OF FL!��
COUNTY OF
COUNTYOF
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The forgoing instru I d d b f re me
this day f 6ent k
OA2 by
e ore me
The forgoing instr t k owledl d b f
thist'�5- day of by
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Name of person ing statement
L��P�
Name of person making statement
Personally Known OR Produced Identif n
icatio
Personally Known __c --EM'Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary F IN6ih � M"n1A UJAZ
Ublic - 8611 Of FlOrldi
MAljlA DIAZ
ignature of Notary IrFu 104wiri Public - state of Florid
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C n # ,
Commission No. M =1810A 'VG 0550 1?
R Sion #,GG 055017
C 1111
ommission No. S )Expires DOC 13, 20
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y - Expires ec 13.202
Bondld
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National Notary As,
through Nall dnal WRY Assr.
off Bonded lt2ough
V - -1 1 U A
REVIEWS
FRONT
ZONING
SUI�.ERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17