HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLe, &b FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I Io)-'®HO-L'
RECEIVED
FEB 08 2019
Building Permit Application
Permitting Department
Planning and Development Services St. Lucie County
Building and Cade Regulation Division
2300 irg ni a Avenue, Fort Pierce FL 34 882
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address:
Aa
Legal Description: %fuArS S -)I. Lucie t�ounly
Property Tax ID#: 3gO3 -701, a020 600 t/ Lot No. :Vo-al
Site Plan Name: Block No. A
Project Name:
Setbacks Front Back:
Right Side:
Left $brie:
/A,:.el 3 41V 115t 3 X 3 ik'e £dy it awd M r *AQ yyeyyI a
rda.{ �tiA�T
_Mechanical
_ Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: 2 i 700,
Cost of Construction: $
Gas Piping
Sprinklers
all mat appiy: may:
_Shutters —Windows/Doors
/
_Generator r/ Roof !Z Pitch
Sq. Ft. of First Floor: got j •706
Utilities: _Sewer _Septic Building Height: /Z
OWNER/LESSEE:
CONTRACTOR.
Name 0 e iKdAlhaias
Name: �S� fj_� ('/�p3er✓IS''
`
Address: 110sr Brchek- Jed
Company: 7i►') ��ac/r/Ifferi+�I". (�s2udfJ
City: prer-e-e Stater
Zip Code: 35r179'Z Fax:
Phone No. 7Z'2- ?YO- Sill %
Address: 1 1/3 /18A JWI A16a4
City: 1-drAilo7C ie i? Stater,[
,Zip Code: IIZ176 Fax:
Phone No .5�o -JOZ - S-41yz
E-Mail: %Ea�/�1/ivS �Whod _ ref"
Fill in fee simple Title Holder on next page (if different'
from the Owner listed above)
E-Mail %Jp(/emevrS/�4RoD
State or County License ree v3 z43&7
It value of construction is Z500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
SUPPLEMENTAL CONSTRUCTION LIEN WIN -MRMA tON:
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 Countyy 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
commencingwork o ecordin our Notice of Commencement.
Rev. 8/2/17
Signature of er/ Lessee/Contractor as Agent for Owner
Signat� of Contractor/License Holder
STATE OF 7011RIDA
STATEOFFLORIDA
COUNTYOFi - IJ.1(',lE_
COUNTY OF �J• LrjC'il�
The forgoing instrument was acknowledged before me
The for oinginstru��++ent was acknowledged before me
this �day of t'e � .20� by
this�dayof G—'P%