HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED n /� K,�
Date: SCANNED 03 Permit Number: I - 05JJ
BY RECEIVED
St. Lucie County
ca MAR 2 1 2019
Building Permit Application
Permitting Department
Planning and Development services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROP„OSED=IMPROVEMENTLOCATIbN
Address: T6li6!CMAR4ES7231V WAY_ /20tr .C72dte/ary_(0 _?V U&
PropertyTax lD #: 33 2/-Sa/w 0 Lot No. 3 /
Site Plan Name: AFf EAVF / A!/A.mf Block No.
Project Name:
4�CONSTRUCTION'ANF,ORNIATION ' " a
Additional work to be performed under this permit -check all that apply:
_Mechanical Gas Tank _ Gas Piping _ Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator vRoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ , ( Utilities: —Sewer —Septic Building Height:
OViINER/CESSEE:i
Name,W&LIAM ,y JZMr hJ
Name: 515 11'r
Address: T6rG ?c1J!Rp Af: C nW w RY
Company: %Inv n
i g- c
City: PORrsrA& yff Stater
Address: 3 3I Sw 2//ir,^
/4 -
City: fai4 sa, 4 1_w ie
State--EL-
Zip Code:3VA06 Fax:
Phone No. 77'j• 80/, "21
Zip Code: 2PL y 53 Fax:
Phone No
E-Mail:/ffAR]YA/LiTA6�O��C�/,LYjUYa{/.w�FT
Fill in fee simple Title Holder on next page ( if different
E-Mail :xo IN S r 6z�E�tilrc c: n,
mc, I • co
from the Owner listed above)
J�
State or County Ucense
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 iLAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City. State: _
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con ict 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
WTTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
t�' %lI/i�si �
-,y
Signature of Owner/ Lessee/Contractor as Agentfor Owner
Sig ature of Co tractor/License Holder
STATE OF FLORIQA I
COUNTY SeJ
E OF FLO �A /^'r ko"
OF A4 ekb
COUNTY OF
The forgoing instru nt was acknowledged before me
this day of C 20_ by
The forgoing instrument w s acknowledged before me
this —"-( day of XtDAA4,L 20 1g by
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/
tiUI��cGrn i�.✓✓den
L.er
Name of person making statement.
Name of person making statement.
Personally Known V OR Prod u"IHExi f%
Personally Known OR Produced Identification
Type of 0.4//.
of I•IAA..p�Z�Wl/
Produelddentification
AN/i
Prode uced celdentification Qttlft
(Signature of Notary P till -Slpte df F o C
(Signature of Notary Publ - rate of�9$a)
Commission No.
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Commission No. all
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REVIEWS
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SUPERVISOR
PLANS
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
ULU
DATE
COMPLETED
ev. 211119