HomeMy WebLinkAboutappAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: [1^Z(0-1 Cf, Permit Number. \dNeJ6-G6S4
_ - RECEIVED
Building Permit Application JUN 25 ^019
Planning and Development Services Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: X%QV&A �r-
Address: 7Sy`l & eva eS /ZJ
PropertyTaxlDit: �3d�"�od3-0�3a"000-`1 LotNo.& /O
Site Plan Name: B o. 14
Project Name: AA
M y-4 n i AID, � X' - -'2 it ',' k New S I ALO X4 Z
2 5 � 3 $ + I� � U 2 e� u-�o xLe°{ -.� '• �.1„ Z� 5 C o n..-I : ,�e:10 �a5
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ f L O o o Utilities: —Sewer _Septic Building Height:
EE
Name qp_L ov _ Name:
Address: 75aN &LvO2y@ v.- Company:
City: hCf •P-,e/r<e State: F( Address:
Zip Code:'jIe7si Fax: City: - Mate:_
Phone No. 771 3 `t t 6S5 1 Zip Code: Fax:
E-Mail: J4CkKiL7M14&(arH ,tVfdheNo
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License
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.
DESIGNE
Name:
Address:
City: State:
Zip: Phone
ica
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:,
Not Applicable
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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."
X -V vJ-C' ' I
Signature of Owner/ Lessee/cpntractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S fie' \ O.Z:%
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this i day of 5 O .no , 20--%'A by
this_ day of , 20_ by
Mock tia+y
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
ProducedI`
Produced
(Signature of Nota ublic- State �MpRIEG 9202''
Ca
t (Signature of Notary Public- State of Florida )
DEAN IS51014 o0od
Commission No. ••- M'(�.pp'O;,aerr+"'YJ
ommission No. (Seal)
BgE,dXedllm�NowY
REVIEWS
FRONT
ONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19