HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLci to FOR APPLICATION TO BE ACCEPTED
Date: / �� Permit Number:
19 198.0,33RECEIVED
�
_—Building-Permit Appl
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
PERMIT TYPE: �h? -b , FL R pv A --
Address:
ation MAR 14 2019
Permitting Department
St. Lucie County, FL
Residential
3
SCANNED
Property Tax ID .2C - 113 - 000 3 Oa/3 - Lot No.
Site Plan Name: Block No.
Project Name:
wr„ccw. I S.-
���� s -,-wN 1 a.- ., vtti ' rrj"cG. C,-i, t7 ram,_..,._, f-F-010 3 - v 33'
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:
Cost of Construction: $10
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/OEESSEE:Ae
GONTRAC TOR:
Name Jo -Ann 7t11,en-ke u
Name: 4tft 1
,,��
Address: 3G�i 5 �n. cW 'ver pA
AA Company:�7V1� �Bi�s Corimoccre
City: Fr Rer-c--- State:
Zip Code: 39`)82 Fax:
Phone No. X01 o qzl
Address: 713Gp S 5 5'sr
City: /T r! i 1r-rGe_ Stater
Zip Code: `v�c/c/� CU Fax:
Phone No 71 39 'Ifs cl
E-Mail: 61(i✓t1 L cc6,a n 0 &z. l 1. �dJ4'1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
/
E-Mail d 1eu"c-GoHTiG.e.TTh-q YJ9cir`l.
'State or County License GQG
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.
SUP LEMEiYi CONSTR O IEN LAW INFORMATIO
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 County makes no representation that is granting a permit.M11 authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws orand.covenants'that• may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any resthctions'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,BEF.ORE THE. FIRST% INSPECTION. IF, YOU INTEND TO OBTAIN -FINANCING, CONSULT
UR: WITH YOLENDER ORGAN ATr6RNEY;BEFORE RECORDING�YOUR NOTICE OF+COMMENCEMENT" ' : • `...
Sign ure of wner/ Lessee/Contractor as Agent for Owner
'
Signature of Contractor/License HolderSTATE
FFLORIDA
STATE OF ORIDA
COUNTY
OF
COUNTY OF
The forgping instrum nt was ac owledge before me
this/ day of 20/ b
�'iY`ZQ C1
The forgoing instru ent was adKPowledged before me
this day of (1uL.L.�� 2p I �y
Name of person making statement.
Name of person daking s atement.
Personally Known OR Produced Identification
Personally Known OR Produced -identification
Type of Identification Produced _ !�
Type of Ide ification•
Produced LJLi7LA�(
,.
(Signature of Notary Public -,State of Florida)
•j=FgQ�O� ,.�- Commission No. ' (SeaIIIASSNA BANABRIA
f N1Y.COMMISSION #FF904036
l,l�/1 Q �I �,I( ,�. EXPIRES: JUL 28, 2019
'r' ( I `�� Bonded tMuugh let State Insurance
e
(Signature of'Notary Public -State ofFlorida .G
YY �//�� • - RASSNA SANABR[A
Commission No. r� 0Y�3 zol Y=`^c� $�(jOMMIS510N#FF90403
• ' s EXPIRES: JUL 28.2019
gnndpd o h let State lnsuran
REVIEWS
FRONT'' :'
PLANS.-
VEGETATION",
SEA -TURTLE`- .:
MANGROVE
ZONING
SUPERVISOR
COUNTER- ..REVIEW
.,.
. REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
RECEIVED
- - • '
DATE
COMPLETED
Rev 2/7/19