HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /J
Date:l"l. SCANNED Permit Number: I9y3 •nh3�.
BY C
rs' • � � �e '� St. Lucie County
• JIVED
Building Permit Appli tion MAR 2 5 Z019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial esl untYr FL
PERMIT TYPE:
;PROPOSED IMPROVEMENT LOCATION:
Address: 6`600 Cobble Sfa>7e a,-
Property Tax ID#: 22--�U&Q0()1 VQ000 Z e Lot No. 1.3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF.WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Block No.
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
XElectric _Plumbing _Sprinklers _Generator k Roof NI Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 3 ��
Cost of Construction: $ OD' Utilities: -Sewer _Septic Building Height:f/21
OWNER/LESSEE:
CONTRACTOR:
Name o 5 e1911 tt
Name:
Address: 9VOO &Weslove,01
Company: OUa E RI/ IL1D61"
City: Fr oie/Ce State:F[,
Zip Code: 3U9yS Fax:
Phone No. ?72,- 370'%67_r
Address: 90100
City: PnLI .Q-LkCIC State: f=.
Zip Code: .34e Fax:
Phone No
E-Mail: R4GctbrdIdeidQ32'14d-(',9n1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
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.
W
8UPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
Nan
Add
LL�G� Not
City: S ate:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
MORTGAGE COMPANY: _A_ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _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 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"
,e L -
daa
ignature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Co tractor/License Holder
STATE OF FLORIDA
COUNTY OF 5k UAU'-
STATE OF FLORIDA
COUNTYOF 6
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The for Ding instrument was acknowledged before me
The forgoing instrument was acknowledged before ;;e^,�;;
this-dayof_MpYbL 20�' by
th�is/Cdayof^t1i711� .201A by
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Name of person making statement.
Name of p rson making statement.
Personally Known P�QgJlblil(/
Personally Known / OR Produced Identificati
_Aff�fOR
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Type of Identification `�� J�5E HOpp /i��
Type of Identification
Produced ���0,.•IONP•
Produced
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of Notary Public -State of FVnd' #GGG' ,•'
(Signature ry �,)
Signature of N t ry Public -State of Flon a )
i` �Pam•'•I'%Bonded n5�oc°: ��
Commission No. "9V•ZFain Iesu�IV s
Commission No. (Seal)
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