HomeMy WebLinkAboutBUILDING PERMIT APPPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTw
----- Building Permit ApplicationLST.
JAN 18 2019.
Planning and Development Services Lucie County, Permi
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED INPROVEMENT LOCATION: SCANNED
Property Tax ID#: 1432—. 805.0043.000 fl Lo No. q3
Site Plan Name: Sherar-6L3 Platt Block No.UNI+2
Project Name: IZemeAldt_ R.et�t2
DETAILED DESCRIPTION OF WORK:
%J,b'TALL_ 5(IbtNti 4Inae Vee)tz- Ito EtrIST7Nh OPENIN4,
IU STALL SWI1.1L, voorL 11J �]�ISTIUti NtA7�,
D1Mp PI-oo3r 1%/ATH^ 1411FAT -
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical
✓Electric.
_ Gas Tank
✓Plumbing
Total Sq. Ft of Construction:
k)A
Cost of Construction: $ 2=4$22 `ao
"
Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:_
Utilities: _Sewer _Septic
windows/Doors
Roof Pitch
�KF
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTWo Aolniw"e, LLC
Name:
Address:5475 N.W. SAIJ�TAMes Drilue Ib3
Company:
City: F6-+ SY, IQC71r State: ,L
Zip Code:31ic% - 34,14 Fax:
Phone No.
Address: &2,? & & AlOe .
City: PSL _ State:
Zip Code: 0eyl'7 ,T Fax: 7%-6,1t/ 79r)
Phone No�'����y`- %ifa
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail-& ag'vpr`9C//aAlcojo t/%shoot a ti
State or County License (` is c t5gZ ?kyo
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.
r•�
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
_
DESIGNER/ENGINEER:_ = Not -Applicable—
-MORTGAGE COMPANY: Not Applicable
Name:ClevelwJiksiao/V.?Gerlet!
_
Name: tirt-
Address: Leos: Ayr- A iigp 2E
Address:
City: P6rt P rt State: Fl
Zip: %"VC5 Phone 772.`1y .2-ro
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
BONDING COMPANY: Applicable
_
Name: IJ11
_Not
Name: UA,
Address:
Address:
City:
City:
Zip: Phone:
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
commencing work or recording our Notice of Commencement.
Signature of tractor/License H d
signature of O er/lessee/contractor a nt for Owner
STATE OF FLORIDAA
STATE OF FLORIDA
COUNTY OF . T o
COUNTY OF QJF
The fo oing instru ent was acknowledge before me
this�dayof ,��a 20 by
The fo ing instr ant was acknowledg r pefore me
thisdayof�20� by
1_PxIrnI�
1'"`
6 uf'rA/ Ln�(
f?o0
Name o person making statement.
Name of pe son making statement.
/
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identificatieft
Produced 1✓
Type of Identification
Produced r 1,
KAREN S. NIELSEN
rp+oo"""�
��:State of Florida -Notary Publi
- Commission # GG 207484
; ti,n+°o'�,, KAREN S. NIELSEN
3a° �¢=State of Florida -Notary Publi
e ' Commission # GG 207484
(Signature of Notary Publi orida une 12, 2oz2
(Signature of Notary Publi flollfilaQommisslon expires
'anin� _June 12, 2022
Commission No. (Seal)
Commission No. Seal)`
REVIEWS
FRONT
ZONING SUPERVISOR
PLAN$
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
EEIVED
F
EMPLETED