HomeMy WebLinkAboutBUIDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED P
Date: Z121 I 19 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Building Permit Appli jo ?o,B
Sr 44,C eo°Un y enr
Commercial Residential
PERMITTYPE: :�)a1C�,C
PROPOSED IMPROVEMENT LOCATION:
Address:
Ci51
Property Tax ID #: I b01- foO5- O 2-11- OOD - g I Lot No.
Site Plan Name: c him**on SUJO. Block No.
Project Name: %c cco \ SLOW
DETAILED DESCRIPTION OF WORK:
IAtJAt1 IkeLD ioo�-rvtnuuleel . Alit��
CONSTRUCTION INFORMATION:
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:
00
Cost of Construction: $ 1 C1,500
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name:'Skx on Swo-ye
Name:
Nmcor-A M aew•S
Address: ✓CiO t FO(+ ejC(C,G 91VCA
Company:`10(061 �U� P LL C--
City: rp (} A-rcce State:
Zip Code: 34Cl51 Fax:
Phone No. t4cn)U U (p"644 y
Address:«26(Q W . F I Or;AO, Aft like 1
City: 1.0}7 Stater
Zip Code: 33S 10 f j Fax:
Phone No 4;(t3 - 38rmc - kl-3,1
E-Mail: `-lGCCOlr)swp pW& ilDktYlfAil Cam
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 6..rY/1,,JIV •Co v.%
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 CONSTRUC
LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _
Name: Nyn GPZC1mAr1
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:I(a60L laannw 9%dd.
Address:
City: L&
Zip:?A64Q Phone
State: _FL_
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
BONDING COMPANY: _Not Applicable
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 Counter 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 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."
kt ni
SlEnature of Owner/ Lessee Contractor qo�Aftnt for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA rj II
STATE OF FLORIDA
COUNTY OF
COUNTY OF
ent was acknowledged before me
The for oing instrument
The forgoing instrument was acknowledged before me
r
this day of1 a6.rb h 20A by
this _ day of . 20_ by
591LVVPK 5wl.av
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 vas c a 5
Produced
Y
ature of Notary Public -State of Florida)
(Signature of Notary Public -State of Florida )
Commission No. a $ V % Id (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER .
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
Notary Public Slate of FloriOa
Daniel Tutsiah
'SUS P.tEMEItITAt£ONSTRUCT19NLf NfAWINFt}12M
�.
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.
'
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 ofapermit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibitsuch
structure. Please consult with your Home Owners Association and review your deed for-anyrestrictionswhich may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, imall 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 RECORDA 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.^'
Signature of Owner/ Lessee/Contractor as Agent Owner
Sign re of Contractor/ ' se Holder
STATE OF FLORIDA
STATE OF FI.O IDA
COUNTY OF
COUNTY'OF L•1i),\Sbor k
The forgoing instrument was. acknowledged before me
The for ing instrument was acknowledged before me
this _dayof 20_ by
thisa%ayaf
Name of person making statement.
Name of person making' statement.
Personally Known .._ OR Produced Identification
Personally Known J,- ORProduced Identification
Type of Identification
Type of Identification
Produced
P ced `S7%7:a'% KAI"- e.DUN4
cl MYCOMMISMOFF9=1
is ' `
FJD'IRESAp71Q2031
>,, s;fif aadeETiw HohryRAOeU
(Signatureof Notary Public -State of Florida)
(Signatu o o ry Public -State of Florida f
Commission No.. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE.
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 277/19