HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.All APFRIICABL1E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED, �I
Date: I�119
Permit Number: �, 6��f i�'�✓�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
RECENED
Building Permit Application MAR 13 1018
Permitting Department
st. Lucie County
Commercial Residential
SCANNED
PROPOSED IMPROVEMENT LOCATION: e+ I .. ..... I
Address:
Property Tax ID #:
Site Plan Name:
Project Name: _
000tl-
Lot No._
Block No.
I DETAILED DESCRIPTION OF WORK: 0 .1
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 3a00 S.�
Cost of Construction: $ 1 (o L{ 0D , () O
Sq. Ft. of First Floor:
Windows/Doors
X, Roof '— Pitch
Utilities: _Sewer _Septic Building Height:JC5
'OWNER/LESSEE;
CONTRACTOR:
Name QP. S . i\rne IZ
Name: 3wS Fo
1 e i
Address:3!I aq S. mockSm'tkh Rg
Company: OV.S e1L5
aR} PitRLP,
City: 15t • p 1 e-p_c j! StateT L.
Zip Code3�yS Fax:
Phone No.rl r7l 2L— �; as- 9 9 $ o
Address:_(jl 0 l d W G ncLn
't)R 1 V e
City: �OR.F' Pi2RC2
Zip Code:'3 tA qg Ql. Fax:
Phone No flrya'- 33a- 4'�ySa
State:.
E-Mail: Corr
Fill in fee simple Ti le Holder on next page ( if different
from the Owner listed above)
E-Mail V 1 C � e— Ok 1 "- 1
a n10.% L - CD
State or County License
It value of construction is 52500 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.
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SUP.PLEMEVNTAL CONSTRUCTION *LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE CO PANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Nqt Applicable
Name:e 5
BONDING COMPANY: _Not Applicable
Name: F
Address:r'3rj� S . RA r�CS rat
Address:
,f1 h
City:'5c L
City:
Zip: 3 AcoA Phone: l
i` — a
Phone
Zip: :
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 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"
The? oinginstru er�twa a owledg�➢gfore me
th'iislf��/ day of 2( �6y
Nam o personmakin atement. (((
M i v al&
Sigma re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF S-= 1 l.4C l lf-i
The focizoing',
this day
Name of person making
Personally Known OR Produced Identification Personally Known N
Type of Idertion 2 Type of Identification
Produced I' aCi ZG�'J�L{�� Produced
me
OR Produced Identification
ISignatureat.Nlntacq'PuMTC-_State f u Notary Pu blic- p•ATHERINE HAVENS
���/�� ������/j��,yr son KATHERINE HAVENS rr�m
Commission N�'i�i__I(_Y,.XJ,..Q� (fJY COMMISSION #GG16 0 missionr°� `n MY �Qf SIGN #GG165030
-I%� •`�"�� a`,�yp EXPIRES: DEC 1 2021 R � ERF'IPE�: DEC 04, 2021
" Bonded through 1st State Ins ranee Bonded through 1st State Insurance
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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PLETED