HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-'w
All APPLICABLE INFO CMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: l 7 Permit Number: 1
s - = a MAR 14 2019
Building Permit Applica ucieCounty, Pefmlttln0
Planning and Development Services SCANNED
Building and Code Regulation Division BY
2300 Virginia Avenue, Fort Pierce FL 34982 S1. LUCIe COurl
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
'PROPOSED IMPROVEMENT LOCATION:
Address: 2-7 S�-, O-SC.nk-L,L L 312—
PropertyTaxID#:3LiI5' -5(.5- l W-loud-- Lot No. 33
Site Plan Name: Block No. a
Project Name:
DETAILED DESCRIPTION OF: -WORK: • - L - -- -
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 _'YRoof Pitch
Total Sq. Ft of Construction: ri �-N) Sq. Ft. of First Floor:
Cost of Construction: $ 660 -GO Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:•
CONTRACTOR:
Name Ak V "r\ 1 h5r� �
Name: \5 r'3
Address: 7 i L:UrvN c S Si
Company l..�C � (yt n)
City: JOQgC &' nh (ti a State EEL
Zip Code: 1)9 5 Sa Fax:
Phone No.i
Address: iti ?� St-:� G
Ht'-rAA1\<-. . -
City: (Ar d L r' i-e— State: t_
Zip Code:3 �) Fax:
Phone No-7-?d d'b'�)-e1SL�
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail (Za o �L rl (CZ'l II
4
Off• (sTy
State or County License 3 l i %64
If value of construction is $2500 or more, a PECORDED 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 INF,ORMATION:,
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 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."
W U
V�ok/ _
Signature of Owner/ Lessee/Contract r s Agent for Owner
Signature of Contractor/License Ho er
STATE OF FLORIDA
STATE OF FLORIIT� JC\�
COUNTY OF s%• `•Oc t--
COUNTY OF
The forgoing instrument was acknowledg before me
The forgoing instrument was acknowledged before me
this � day of �q C 20A by
this � day of"�Q 20\ by
Name of person making statem nt.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identif cation
Produced L�
Produced
(Signature of Notary Public- State of Florida)
(Signature of No — u
,.•,:n,:; '••.. GEANNAMARI GIVENS
Commission Nodaad o
COMIdISslo G 22023
CO ,mission No. a IRES: Dece 2020 ,
ONgMARIEGIVEN°
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