HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,.•�. s
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u L�
Date: QA a•5 Permit Number:
Building Permit App
FEB 2 b 2019
Lucia
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V� SCANNE
MV
PERMIT TYPE: a p t ci.ehn a qar o q e_ St. Lucie'
PROPOSED IMPROVEMENT LOCATION:
Address:-1406 'rehS0kC'o\cA- 'RI , r k, `P iecce tFL_ 3gg51
Property Tax ID #: \1P01- (oob - O WAD-o c,0/x Lot No. (O d. 0
Site Plan Name: Block No. 6
Project Name:
DETAILED DESCRIPTION OF WORK:
e>uiit,nc ao' -e- Aa" Coro\;oo.
CONSTRUCTION INFORMATION:
0
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:
44 O
Sq. Ft. of First Floor: 4`i 0
Cost of Construction: $ Lo %
l 02L• oo
Utilities: —Sewer _Septic
Building Height: t
OWNER/LESSEE:
CONTRACTOR:
Name �mhn L.ompor�t
Name: 5%pc�iar � Sheds
Address:1406'Teri auceb.. 'R a •
Company:
City:(j• 'Pt¢rce, r L State:F�
Zip Code:$Lk%st Fax:
PhoneNo.-1Z'J.- S734- 7.5Z.1
Address:LelbS 5. M•S, d'6.
City:F+, 'Pyt1c.e , State:l=L-
Zip Code: 344155(3 Fax:-1Ia-460-4615%
Phone No'I-la1 -4too -'1poe
E-Mail: s1rAor% @jL14tie0.eoM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail w w w • sine et %ar,51-ted s . c orW
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:$cch&6I. Error%neerih�b�Ce3tiroa�
MORTGAGE COMPANY: veNotApplicable
Name:
Address:tao5 W. New t1otk Aue.
Address:
City:-0fAQna State:F�
-Zip:31Zo—Phone3$-b=1'+V 94`I`( -
City: State:
-Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: 16�nn *--l4k in Lcrmptni
BONDING COMPANY: ✓Not Applicable
Name:
Add ress:'1ao 6 '?yrt%aco\o 'tRd.
Address:
City:FF.'Pt_cKr, (^L SARNI
City:
Zip:3`19s1 Phone:-111 83q ?Sl7
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
no
!e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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."
I
Signature of Owner/ Less a/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrume t was acknowledged before me
The forgoing instrument was acknowledged before me
thisANay of FO�V� 20 by
this day of . 20_ by
Name of person -making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of lde
Type of Identification
Produced L% J)L
f lF7�YLlitA.i f1°'-
Produced
(Si at of Jqotary Public- Statr,of,Ekorida )
(Signature of Notary Public- State of Florida I
�� ..., t, MAI AL HUSUN
Commission No. * i(jQ'�jQMSSION►FF94=
Commission No. (Seal)
E] 1FIES: Ag 9, 2o20
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I O�
RECEIVED
I { 1
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COMPLETED
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