HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr:: APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
ici_.-=.:-p=t��,.,,r �5,w�.•.=erwey RECENED
_ JAN 2 4 2019
® Permit I� pp��
Building Permit Application ermitting
Department
.='anm'ng and Development Services St. Lucle County
.u;d:ng and Cade Regulation Division i
300 Virginia Avenue, Fort Pierce FL 34982
on�2) 462-1S53 Fax: (772) 4bTi578 Commercial Residential �C9
P' c iV1iT TYPE: 419
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A�taress: s�Vdi P11�Ma�iC9 �2..
;ioParty-iaxID#:. 3y��i—St) i — IDQ— 3 0Lot No.
-;ta clan Name: Block No.
r�jsc: Name:
iLE DE5,CRIP, T iC>N Or
of
,frLl`7iC�t !NFOR1VdATIONI e r« ;�
, ddi r1onal workte be performed under this permit- check all that apply:
Mechanical —Gas Tank —Gas Piping _Shutters —Windows/Doors
�y[
-'
e ec'_ricPlumbing —Sprinklers Generator Roof Pitch
— —
o;a! Sq. Ft of Construction: 170 Sq. Ft. of First Floor: i oa
Cost of Construction: $ 130, 040 "` Utilities: -Sewer Septic Building Height:
rx r w .. i4 !§,'' R ''
1ER, �5 , '" .. +,
-
CONTRACTOR_
--'�-
anr_-mil r+e3 S\ 4`
Name:-_ �h�1A1Lti Sc�r�C�r
.address: 5�_oi PA,tti�t! Ve
Company: �0"_ i�3bn`a �N�h�O�arc3
City: 5tate:� t
Address: 31�1 SW NYcy N _Texf
:.:fCode: 2>t�Lcj SSa. Fax:
City: PbYk a'Ltn_'z State:
none No.
Zip Code:3Vh0\gy Fax:1 S- 9-
L-Mail:
Phone No 5zk�R^Isola
fl is -:ee simple Titla Holder on next page (if different
E-Mail `-a-a1 SG�i �. V-f "vu i UN..
State or County License ULc 1 'YONIU
o, n the owner listed above)
vee m cunauucoun rs a<5oo or more, a RECORDED Nonce of Commencemem: is requirea.
wise of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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FLLM rKfi�,AL CONSTRUCTION LIEN LP W ,,QRMAi lOIV 1",ji
4
<t t a
,
C,:S,IGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
? 3.
ame:
- &css:
Address:
City: State:
State:
Phone
Zip: Phone:
!:,zE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
,:a•
_Not
Name:
,fie ress:
Address:
City:
Phone:
Zip: Phone:
JiNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
rtfy that no work or installation has commenced prior to the issuance of a permit.
' -,.cie Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
a; is in contlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
c.:ure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
,- crsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
zo-dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
following building permit applications are exempt from undergoing a full concurrency review: room additions,-
acc:ssory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
:=.itllNG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
Ic-,provements to your property. A Notice of Commencement must be recorded and posted on the jobsite
t�rore the `first inspection. If you intend to obtain fina ith lender or an attorney before
-
1.:; ^.".-riencinR work or recording our Notice of Com ncemen .
i
n�tu n for ner
ctLicense Holder
SigN0R`,DAr'
m ;:=TE OF FL A tt rr--
STiJSdTY
OF l�
CO
e fnr�9ing instru�nt was knowledge before me
The for oing instrument was ac owledged before me
=: Is o» day of ( 2QI, by
this y of 20194 G by
a.ame of person making statement.
Name of person making statement.
Dersunally Known OR Produced Identification
Personally Known OR Produced Identification
'vpe of Identification
�%i� ��
Type of Identification
=-od-,ced_
Produced—
i
I
\
(Signature of dli - t le BNobt��CiHN
>i;natw
,���+,,,:gtriSte
dlw ... ELLEN VAUpFIfI
C,rr,-r. . "° 3tato 0f Plorlda-N0 bile
of Iorlde-Notary Public
Commission p
Commission $Pp07B
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My Gbinmieel®ry Ex if®s
""' October 22 20221rea
�.EViEWS
FRONT Z
ERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
1-CElVED
'afE
COMPLETED