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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 D Date: / Ofo1� Permit Numb n KCILLIWE CE8 ?me RE: - ®, JAN 2 2 2019 Buildino...ermit Application — Permitting Permitting Department Building and Code Regulation Division _ _ St. Lucie Co. 2300 Virginia Avenue, Fort Pierce FL 34982 --r-�)-- Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 9 ED BY PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of llnSt. Lucie County PRr1P(1SFflINtPRrI\/FMGNTIG1GATt(tN a .t. Address: /0 -7 Agucii P4 br .J f,"-sEri &,ftA 3 C15 Legal Description: FIW r- k)AIcti &LK.5 Lo4 Property Tax ID #: W Si 1 - 9'/S • Ooi 9- 0002-T Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: �. �o-�I `DETAIL'ED DESCRIPT10NeOF WORK �/�'I PRGi� e.� c�Osvcc o.�- e,cS/err^y Ga ✓cr�� P4 �� HULIMUIIGI WUIK LU UC E1HVAC CI IUMMU Tank UIIUCI L111] ❑Gas PC11111L—L.IICL.K tl11 dpply. Piping ❑Windows/Doors _Gas _Shutters Electric 0 Plumbing Sprinklers Generator Roof Roof;pitS�"" Total Sq. Ft of Construction: � 2c� S Ft. of First Floor: Cost of Construction: $ i !1 , KLUtilities: Sewer Septic Building Height: /S CkWNER/LESSEE:: _ CONTRAC'OR:<.F„ , Name t ctr) Name: (hen! S A NTT- Address: l o-i A que; L ,SnFe1ro_ Company: _'v `�Ct1 S C41\S fi/ �Y�G : rl Address: tO2 5, Y(e / City: ten Sen �e4eh State: L Zip Code: _ '�c{ 16 7 Fax: Phone No. City: Zs- kn,4 State: N L Zip Code: 33Y6y Fax: Phone No. _5'6 S 7Sz3 - jSSOp E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: °' 7�c> — O State or County License: ' , 1�- If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. r , SUR LEMENTALCON$TRUCTIQN LIEN LAW INFORMATION _5 DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name:�S ;" ( Name: Address:-13(DU tJUJ 5 �' Ck-ef �— Address: City:i� 0. Orl State: IF L. City: State: Zip: S- 1-1 Phone G54 Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: _Name: 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 contlict 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 orrecording vour Notice of Commencement. Signature caner/ Lessee/Contractor Agent for Owner Sigfiature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF I .LA C L t COUNTY OF 237F. Ll I N The for g mstruumee t was acknowledged before me this day of , IffN LIAQ . 201Q by The forRing instrument was acknowledge before me this day ofc%Ai LG 20 by 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 Produced ILL Produced (Signature of NAtary Public -State of Florida (Signature of N ary Public- State of Florida ) �arcv WOUINTANA ..... "s;Pu AMYQUINTANA % Commission No. Com(6�0pNGG13029d r° Commission No. Won y s Explres December 1, 2021 explios 9 In b9t 112021 . /�E,°rF�°� BVId�ETAN9WpKNohiYSRlima "�•oERt Isaete9fPtnseAgelF�O'�res REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE I5 RECEIVED DATE COMPLETED - Rev.8/2/17 1Cr