HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONArl APPLICABLE INFO MUST BE COMPLEOFOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
BY
SdWieC090W RECEIVED
Building Permit Application
FEB 0'4 1019
Planning and Development Services Permitting Department
Building and Code Regulation Division 5t, t tacle County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 . Commercial Residential
PERMIT TYPE: 9
Address: -70 C-'INS LSIlld
Property Tax ID#: 3g0 C` 3 - 0(50 - C)00�
Site Plan Name:
Project Name:
EO°DESCRIPTION OF WORK::
u) 9--)e-4-zr,n.- I.-).^Ar;
Lot No.
Block No.
Mw) '9' \ QX-A 6 C 0 A V tit.uJ `i'O,
0Y-1
y
['CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters
Electric ; Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: aq -SF Sq. Ft. of First Floor:
Cost of Construction: $ -CIO, OctO' Utilities: —Sewer _Septic
i< Windows/Doors
Roof Pitch
Building Height:
OWNER/ESSEE
CONTRACTOR
Name o Jr)1-(�)
Address': �� OSGp Aok bj"
Name: -F(-2 u.v i.er
Company: v�. o. Pk . 'bXVd
City: F0 4 }�; �-� State: ti.
Zip Code: zqq Ya Fax:
Address: 10 I : ok- cJC AJ►-
City: `1�ir� S-�. Lvi�� state: l`L
Phone No.
Zip Code: 3LA 5 5 Fax:
E-Mail:
Phone No l-1�- 5-7 a
Fill in fee simple Title Holder on next page ( if different
E-Mail i'�-O�n, k` a q I D ®�� M a.. L cv M
State or County License C C. (A Q bj
from the Owner listed above)
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
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 represents �ari(that' is,granting a.permit will authorize the permit holder to build the subject structure
which is in conflict with any applicalil 141a&,O.wn&§S-A§s6�iation 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 fail a to Record a Notice of Commencement may re It in your paying twice for
improvements to your�ope • . A Notice of Commencement mus a reco de and posted on the jobsite
before the first insp c`ti h._ ou intend to obtain financing, co I wit a er o attorne efore
com encin wor or r c In Notice of Commencerseo?
4v;o
Signature of Owner ss /Contractor as Agent for Owner
Signatu of Contrac r/Lice tita Holder
STATE OF FLORIDA S,J, 1 �`n
COUNTY OF
STATE OF COUNTY OFORIDA G �C�C
11t l�
The forgoing instrument was acknowledged before me
The forgoing instrument as acknowledged before me
this day of �= . 20_ by
this day of 20_ by
JL
R n
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
FL r) �"
Type of IdentificationN L
L
Produced
Produced 1) ,
(Signature of
(Signatu
a
os'�"'U°� ELLEN VAUGHN'
== o_State of Florida -Notary
•_
Commission
Commission
ELLEN VAUGHN
ar° `�- State of Florida -Public
Commiss
_
;9 e:' sion # GG 270079
% OFFl-OPT My Commission Expires
GG_ 270
� °P " M Commission Expires
p
°/O F���` y0ctober
llllllll\�
2 . 0
REVIEWS
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
FRONT
ZONING
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 9/26/18